Can reversal of RYGB also reverse hypoglycemia?

Arora, Ipsa; Patti, Mary‐Elizabeth

doi:10.1016/j.molmet.2018.01.004

Cited by 10 publications

(8 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Rare individuals with PBH continue to have episodic hypoglycemia despite continuous G-tube feeding. In this setting, reversal of the surgical procedure toward normal anatomy may be considered, when feasible; while this typically improves hypoglycemia, it does not always fully resolve hypoglycemia, [97][98][99][100] and may result in additional (but typically modest) weight regain. 101,102 While initial reports describing PBH utilized pancreatectomy to reduce hypoglycemia, pancreatectomy is no longer considered as an appropriate therapy for the majority of patients with severe PBH for several reasons.…”

Section: Additional Therapiesmentioning

confidence: 99%

<p>Hypoglycemia After Upper Gastrointestinal Surgery: Clinical Approach to Assessment, Diagnosis, and Treatment</p>

Sheehan¹,

Patti²

2020

DMSO

View full text Add to dashboard Cite

Section: Additional Therapiesmentioning

confidence: 99%

<p>Hypoglycemia After Upper Gastrointestinal Surgery: Clinical Approach to Assessment, Diagnosis, and Treatment</p>

Sheehan¹,

Patti²

2020

DMSO

View full text Add to dashboard Cite

“…Knockout mice were protected from hyperglycaemia-evoked vasoregression and STZ-induced thinning of the retinal layer. These effects may be due to a role of TRPC channels in the regulation of expression/activity of glyoxalase 1 (GLO1), a key enzyme involved in the detoxification of the reactive metabolite methylglyoxal [ 109 ]. The exact nature of the channels involved in this phenotype is not known, and the effect of pharmacological TRPC1/4/5 modulators has not been reported yet.…”

Section: Using Small Molecules To Unravel (Patho)physiological Rolmentioning

confidence: 99%

Remarkable Progress with Small-Molecule Modulation of TRPC1/4/5 Channels: Implications for Understanding the Channels in Health and Disease

Minard

Bauer

Wright

et al. 2018

Cells

View full text Add to dashboard Cite

Proteins of the TRPC family can form many homo- and heterotetrameric cation channels permeable to Na+, K+ and Ca2+. In this review, we focus on channels formed by the isoforms TRPC1, TRPC4 and TRPC5. We review evidence for the formation of different TRPC1/4/5 tetramers, give an overview of recently developed small-molecule TRPC1/4/5 activators and inhibitors, highlight examples of biological roles of TRPC1/4/5 channels in different tissues and pathologies, and discuss how high-quality chemical probes of TRPC1/4/5 modulators can be used to understand the involvement of TRPC1/4/5 channels in physiological and pathophysiological processes.

show abstract

“…A summary of published cases treated with reversal surgery reported some improvement in frequency of hypoglycemic events in 12 of 17 affected patients [2]. Glycemic improvement after reversal surgery is often associated with weight regain and delayed gastric emptying, therefore the use of this option is only considered for treatment of refractory cases [35]. Long-term feeding through G-tube is also utilized in some institutions for patients who are not interested in reversal procedure.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Postprandial hypoglycemia after gastric bypass surgery

Honka¹,

Salehi

2019

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

View full text Add to dashboard Cite

Purpose of review-The Roux-en-Y gastric bypass surgery (RYGB) improves glucose control in majority of patients with type 2 diabetes. However, a minority group of individuals develop a life-threatening complication of hyperinsulinemic hypoglycemia. The goal of this review is to identify underlying mechanisms by which RYGB cause hypoglycemia and describe pathogenesisdriven strategies to diagnose and treat this condition.Recent findings-Gastric bypass leads to higher and earlier peak levels of glucose and lower nadir glucose after eating along with larger insulin and glucagon-like peptide 1 (GLP-1) secretion, resetting the balance between glucose appearance and clearance after this procedure. These weight-loss independent glycemic effects of RYGB have been attributed to changes in ingested glucose appearance as a result of rapid nutrient emptying from stomach pouch to the intestine and increased glucose clearance as a result of prandial hyperinsulinemia. The exaggerated effect of RYGB on postmeal glucose metabolism is a syndrome of postprandial hyperinsulinemic hypoglycemia manifesting in a group of individuals several years after this surgery. Affected patients have larger systemic appearance of ingested glucose and greater postmeal secretion of insulin and GLP-1 compared to those with history of RYGB without symptomatic hypoglycemia. Current evidence supporting a multifactorial model of glucose dysregulation among patients with hypoglycemia will be highlighted in this review.Summary-Hypoglycemia after RYGB is a life-threatening condition and likely represents the extreme glycemic phenotype of this procedure. Diagnosis is challenging and treatment options are limited.

show abstract

Can reversal of RYGB also reverse hypoglycemia?

Cited by 10 publications

References 10 publications

<p>Hypoglycemia After Upper Gastrointestinal Surgery: Clinical Approach to Assessment, Diagnosis, and Treatment</p>

<p>Hypoglycemia After Upper Gastrointestinal Surgery: Clinical Approach to Assessment, Diagnosis, and Treatment</p>

Remarkable Progress with Small-Molecule Modulation of TRPC1/4/5 Channels: Implications for Understanding the Channels in Health and Disease

Postprandial hypoglycemia after gastric bypass surgery

Contact Info

Product

Resources

About