Post-bariatric hypoglycaemia

Abstract

Awareness of post-bariatric hypoglycaemia has increased in recent years. The condition appears to be more prevalent than previously estimated, when mild to moderate cases are taken into account. Most patients respond well to dietary adjustments, while a small proportion may require assistance or experience seizures or syncope. Hypoglycaemia is associated with both weight-dependent and weight-independent mechanisms. Key factors include improved insulin sensitivity and increased secretion of incretin hormones such as glucagon-like peptide 1 (GLP-1). The primary goal of treatment is to minimise the postprandial fluctuations in blood glucose and insulin levels. Although certain medications may help to alleviate symptoms, they are rarely used. This clinical overview aims to raise awareness of hypoglycaemia following bariatric surgery and to highlight key considerations for healthcare professionals who encounter these patients.