Hypoglycemia after GBP 10 min V Congreso Internacional de Cirugia Bariatrica y Metabolica Mendoza Argentina May 19 & 20, 2...
0.2% incidence of admission for hypoglycemia
Molecular mechanisms that lead to congenital hyperinsulinemic hypoglycemia
Mechanisms of action <ul><li>Dumping syndrome: ↑ insulin secretion </li></ul><ul><li>↑  insulin sensitivity unmasking fami...
 
 
 
Medical Management <ul><li>Dietary optimization </li></ul><ul><li>Diazoxide </li></ul><ul><li>Octreotide </li></ul><ul><li...
Surgical Options <ul><li>Increase restriction </li></ul><ul><li>Reversal </li></ul><ul><li>Revision </li></ul><ul><li>Panc...
 
Pancreatectomy Mayo 6 patients 3 cured 2 occasional sx 1 more severe sx Indiana 9 patients 2 cured 3 occasional sx 2 medic...
 
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Hipoglucemia post by pass gástrico

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Hipoglucemia post by pass gástrico

  1. 1. Hypoglycemia after GBP 10 min V Congreso Internacional de Cirugia Bariatrica y Metabolica Mendoza Argentina May 19 & 20, 2011
  2. 2. 0.2% incidence of admission for hypoglycemia
  3. 3. Molecular mechanisms that lead to congenital hyperinsulinemic hypoglycemia
  4. 4. Mechanisms of action <ul><li>Dumping syndrome: ↑ insulin secretion </li></ul><ul><li>↑ insulin sensitivity unmasking familial hyperinsulinemia </li></ul><ul><li>Lack of regression of β-cell mass </li></ul><ul><li>GLP1-mediated active expansion of β-cell mass </li></ul>
  5. 8. Medical Management <ul><li>Dietary optimization </li></ul><ul><li>Diazoxide </li></ul><ul><li>Octreotide </li></ul><ul><li>Calcium channel blocker </li></ul><ul><li>Acarbose </li></ul>
  6. 9. Surgical Options <ul><li>Increase restriction </li></ul><ul><li>Reversal </li></ul><ul><li>Revision </li></ul><ul><li>Pancreatectomy </li></ul>
  7. 11. Pancreatectomy Mayo 6 patients 3 cured 2 occasional sx 1 more severe sx Indiana 9 patients 2 cured 3 occasional sx 2 medical tx 2 refractory G. Service, MD V. Mathavan, MD 2 patients developed DM

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