A patient may develop post-prandial hypoglycemia following gastric bypass.
Pathophysiology: associated with inappropriate hyperinsulinemia. Patients show increased post-prandial glucagon-like peptide (GLP-1).
Clinical features:
(1) history of bariatric surgery, usually Roux-en-Y procedure
(2) onset of hypoglycemia 1-3 hours after a meal
(3) associated with hyperinsulinemia
(4) triggered by carbohydrate-rich foods
(5) usually responds to dietary restrictions
Dietary restrictions:
(1) low carbohydrate intake
(2) avoidance of simple sugars
(3) avoidance of foods with a high glycemic index
