{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:17:00Z","timestamp":1784557020626,"version":"3.55.0"},"reference-count":10,"publisher":"Bioscientifica","issue":"4","license":[{"start":{"date-parts":[[2023,10,1]],"date-time":"2023-10-01T00:00:00Z","timestamp":1696118400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["edm.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,10,1]]},"abstract":"\n Summary<\/jats:title>\n There is a scarcity of literature relating to post-bariatric hypoglycaemia (PBH) in pregnancy. Recurrent hyperglycaemia and hypoglycaemia can have significant consequences for both the mother and the developing fetus. We describe a case of a young pregnant woman who was diagnosed with symptomatic PBH in the second trimester of pregnancy using continuous glucose monitoring (CGM) 3 years after Roux-en-Y gastric bypass (RYGB) surgery. Instigating a low glycaemic index and complex carbohydrate diet significantly improved the patient\u2019s glycaemic excursions. Given that this condition is likely underdiagnosed as a complication of RYGB surgery, a greater awareness of this complication is needed. Patients should be adequately consented pre-operatively for this relatively frequent late surgical complication to enable patients to identify symptoms of this condition at an early stage and seek medical treatment.<\/jats:p>\n <\/jats:sec>\n \n Learning points<\/jats:title>\n \n \n PBH is an important diagnosis in patients post-RYGB surgery, particularly in women of childbearing age when consequences of both hyperglycaemia and hypoglycaemia during pregnancy can adversely affect both mother and the fetus.<\/jats:p>\n <\/jats:list-item>\n \n Adverse outcomes of recurrent hypoglycaemia to the fetus can include small for gestational age, intrauterine growth restriction and possible impairment of beta cell function.<\/jats:p>\n <\/jats:list-item>\n \n Providing adequate carbohydrate intake to allow growth of the fetus during pregnancy while also attempting to resolve both hyperglycaemia and hypoglycaemia associated with PBH by reducing the intake of simple carbohydrates and high glycaemic index foods can prove challenging.<\/jats:p>\n <\/jats:list-item>\n \n Patients should be adequately consented for late complications of RYGB surgery such as PBH in order to allow early recognition of symptoms and enable prompt treatment.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:sec>","DOI":"10.1530\/edm-23-0010","type":"journal-article","created":{"date-parts":[[2023,10,3]],"date-time":"2023-10-03T10:05:46Z","timestamp":1696327546000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-2","source":"Crossref","is-referenced-by-count":1,"title":["Post-bariatric hypoglycaemia diagnosed during pregnancy"],"prefix":"10.1530","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0365-9196","authenticated-orcid":true,"given":"Dave","family":"Duggan","sequence":"first","affiliation":[{"name":"Waikato Regional Diabetes Service, Te Whatu Ora Health New Zealand, Hamilton, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cinthia Minatel","family":"Riguetto","sequence":"additional","affiliation":[{"name":"Waikato Regional Diabetes Service, Te Whatu Ora Health New Zealand, Hamilton, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"bib1","series-title":"Diabetologia","first-page":"2307","article-title":"Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986\u20132006 in Sweden","volume":"53","author":"Marsk","year":"2010","unstructured":"Marsk RJonas ERasmussen F & N\u00e4slund E. Nationwide cohort study of post-gastric bypass hypoglycaemia including 5,040 patients undergoing surgery for obesity in 1986\u20132006 in Sweden. Diabetologia2010532307\u20132311. (https:\/\/doi.org\/10.1007\/s00125-010-1798-5)"},{"key":"bib2","series-title":"Journal of Clinical Endocrinology and Metabolism","first-page":"4563","article-title":"Incretin hypersecretion in post-gastric bypass hypoglycemia--primary problem or red herring?","volume":"92","author":"Vella","year":"2007","unstructured":"Vella A & Service FJ. Incretin hypersecretion in post-gastric bypass hypoglycemia--primary problem or red herring?Journal of Clinical Endocrinology and Metabolism2007924563\u20134565. 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(https:\/\/doi.org\/10.1186\/1471-2393-12-23)"},{"key":"bib8","series-title":"Journal of Surgical Research","first-page":"199","article-title":"Hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass: unraveling the role of gut hormonal and pancreatic endocrine dysfunction","volume":"167","author":"Rabiee","year":"2011","unstructured":"Rabiee AMagruder JTSalas-Carrillo RCarlson OEgan JMAskin FBElahi D & Andersen DK. Hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass: unraveling the role of gut hormonal and pancreatic endocrine dysfunction. Journal of Surgical Research2011167199\u2013205. (https:\/\/doi.org\/10.1016\/j.jss.2010.09.047)"},{"key":"bib9","series-title":"Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients)","first-page":"292","year":"2005","unstructured":"IOMGuidelines. Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids (macronutrients). Institute of Medicine, p. 2922005. Available at: http:\/\/www.nap.edu\/catalog\/10490\/dietary-reference-intakes-for-energy-carbohydrate-fiber-fat-fatty-acids-cholesterol-protein-and-amino-acids-macronutrients"},{"key":"bib10","series-title":"Drugs in pregnancy and lactation: a reference guide to fetal and neonatal risk","author":"Briggs","year":"2017","unstructured":"Briggs GGFreeman RKTowers CV & Forinash ABDrugs in pregnancy and lactation: a reference guide to fetal and neonatal risk. 11th ed.Philadelphia, PA: Wolters Kluwer2017."}],"container-title":["Endocrinology, Diabetes & Metabolism Case Reports"],"original-title":[],"link":[{"URL":"https:\/\/edm.bioscientifica.com\/view\/journals\/edm\/2023\/4\/EDM23-0010.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2023\/4\/EDM23-0010.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/edm.bioscientifica.com\/downloadpdf\/journals\/edm\/2023\/4\/EDM23-0010.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:48:10Z","timestamp":1784555290000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/edm\/article\/3650"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,1]]},"references-count":10,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.1530\/edm-23-0010","relation":{},"ISSN":["2052-0573"],"issn-type":[{"value":"2052-0573","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,1]]}}}