{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:20:55Z","timestamp":1773112855112,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,11,27]],"date-time":"2024-11-27T00:00:00Z","timestamp":1732665600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>Post\u2010bariatric hypoglycemia (PBH) is a complication of bariatric surgery including Roux\u2010en\u2010Y gastric bypass (RYGB). It remains unclear why only some individuals develop PBH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify clinical characteristics distinguishing post\u2010RYGB individuals with PBH, versus without symptomatic hypoglycemia (RYGB non\u2010hypo).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and Setting<\/jats:title><jats:p>Cross\u2010sectional observational study in academic referral centre. Adults 18\u201370, without current diabetes, were recruited into three groups: (1) PBH (<jats:italic>n<\/jats:italic>\u2009=\u200939); (2) RYGB non\u2010hypo (<jats:italic>n<\/jats:italic>\u2009=\u200925); and (3) individuals without history of upper gastrointestinal surgery (<jats:italic>n<\/jats:italic>\u2009=\u200917). Outcome measures included between\u2010group differences in medical history and medication use, and survey\u2010based scores for hypoglycemia, dumping syndrome, and autonomic symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>PBH participants were 92% female, age 53.4\u2009\u00b1\u200911.9\u2009y, BMI 31.2\u2009\u00b1\u20095.6\u2009kg\/m<jats:sup>2<\/jats:sup>, versus RYGB non\u2010hypo (100% female, age 53.2\u2009\u00b1\u200910.5\u2009y, BMI 32.2\u2009\u00b1\u20098.0\u2009kg\/m<jats:sup>2<\/jats:sup>) and controls (65% female, age 44.5\u2009\u00b1\u200914.6\u2009y, BMI 30.8\u2009\u00b1\u20096.3\u2009kg\/m<jats:sup>2<\/jats:sup>). 87% of PBH reported level 3 hypoglycemia, with emergency visits in 28% and vehicle accidents in 8%. Reduced hypoglycemia awareness was reported by 82%; 13%\u201317% were classified as unaware (modified Clarke\/Gold scores). Preoperative hypoglycemia symptoms and family history were reported by 26% and 18% of PBH. PBH had significantly higher survey scores for hypoglycemia, dumping syndrome, and autonomic symptoms, and higher self\u2010reported neuropathy, autonomic neuropathy, orthostatic hypotension, reflux esophagitis, intestinal dysmotility, and IBS (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05 vs. RYGB non\u2010hypo). Gabapentin and PPI use was more frequent in PBH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High rates of IBS, dumping symptoms, and orthostatic hypotension suggest disordered autonomic regulation as a potential contributor to PBH. Self\u2010reported preoperative symptoms and family history of hypoglycemia suggest possible preoperative differences in glucose metabolism in PBH.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15169","type":"journal-article","created":{"date-parts":[[2024,11,28]],"date-time":"2024-11-28T04:44:24Z","timestamp":1732769064000},"page":"111-120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Defining Clinical Characteristics of Individuals With and Without Post\u2010Bariatric Hypoglycemia After Gastric Bypass"],"prefix":"10.1111","volume":"102","author":[{"given":"Ashna","family":"Grover","sequence":"first","affiliation":[{"name":"Research Division Joslin Diabetes Center Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Farahmandsadr","sequence":"additional","affiliation":[{"name":"Research Division Joslin Diabetes Center Boston Massachusetts 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