Postbariatric surgery hypoglycemia: Nutritional, pharmacological and surgical perspectives

Diabetes Metab Res Rev. 2024 Feb;40(2):e3750. doi: 10.1002/dmrr.3750. Epub 2023 Nov 28.


Post-bariatric hypoglycaemia (PBH) is a metabolic complication of bariatric surgery (BS), consisting of low post-prandial glucose levels in patients having undergone bariatric procedures. While BS is currently the most effective and relatively safe treatment for obesity and its complications, the development of PBH can significantly impact patients' quality of life and mental health. The diagnosis of PBH is still challenging, considering the lack of definitive and reliable diagnostic tools, and the fact that this condition is frequently asymptomatic. However, PBH's prevalence is alarming, involving up to 88% of the post-bariatric population, depending on the diagnostic tool, and this may be underestimated. Given the prevalence of obesity soaring, and an increasing number of bariatric procedures being performed, it is crucial that physicians are skilled to diagnose PBH and promptly treat patients suffering from it. While the milestone of managing this condition is nutritional therapy, growing evidence suggests that old and new pharmacological approaches may be adopted as adjunct therapies for managing this complex condition.

Keywords: bariatric surgery; complications; dumping syndrome; gastrectomy; obesity; post-bariatric hypoglycemia.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery* / adverse effects
  • Blood Glucose / metabolism
  • Gastric Bypass*
  • Humans
  • Hypoglycemia* / diagnosis
  • Hypoglycemia* / etiology
  • Hypoglycemia* / therapy
  • Obesity / complications
  • Obesity, Morbid* / surgery
  • Quality of Life


  • Blood Glucose