Post-prandial Hypoglycemia after Bariatric Surgery: Pharmacological Treatment with Verapamil and Acarbose
Post-prandial Hypoglycemia after Bariatric Surgery: Pharmacological Treatment with Verapamil and Acarbose
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DOI：
10.1007/s11695-008-9569-9
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发表时间：
2008-12-01
期刊：
影响因子：
2.9
通讯作者：
Coutinho, Walmir F.
中科院分区：
文献类型：
--
作者：
Moreira, Rodrigo O.;Moreira, Rustan B. M.;Coutinho, Walmir F.
餐后低血糖是减肥手术的常见并发症。它通常由晚期倾倒综合征引起，但已经描述了其他一些原因，包括胰岛素瘤和非胰岛素瘤胰源性低血糖综合征（NIPHS）。考虑到NIPHS是一种最近才被描述的综合征，而且非常罕见，治疗方法仍然不是双方同意的。我们报告一例26岁的女性接受减肥手术，16个月后出现间歇性餐后低血糖发作。空腹c肽、胰岛素、血糖正常。由于NIPHS的可能性，临床治疗开始使用维拉帕米和阿卡波糖，导致低血糖发作及其严重程度显著降低。手术是NIPHS最常见的治疗方法。然而，在轻度或中度症状的情况下，考虑药物治疗的可能性是很重要的。至少在一段时间内，这种方法可以在不需要积极手术的情况下改善症状。
Postprandial hypoglycemia is a common complication of bariatric surgery. It is usually caused by late dumping syndrome, but a few other causes have already been described, including insulinoma and noninsulinoma pancreatogenous hypoglycemic syndrome (NIPHS). Considering that NIPHS is a recently described syndrome and is also very rare, therapeutic approaches are still not consensual. We report the case of a 26-year-old woman who was submitted to bariatric surgery and presented episodic postprandial hypoglycemic episodes after 16 months. Fasting C-peptide, insulin, and glucose were normal. Because of the possibility of NIPHS, clinical treatment was initiated with verapamil and acarbose, leading to a significant reduction of hypoglycemic episodes and also their severity. Surgery is the most common approach to NIPHS. However, in cases of mild or moderate symptoms, it is important to consider the possibility of pharmacological treatment. This approach may result, at least for some time, in an amelioration of symptoms without the need of an aggressive procedure.