Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Porto, Portugal.
Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Building 1.3, 4050-313, Porto, Portugal.
Obes Surg. 2020 Jan;30(1):249-255. doi: 10.1007/s11695-019-04147-1.
BACKGROUND/AIM: The need to improve post-bariatric hypoglycemia (PBH) diagnosis and clinical management is well recognized. Our aim was to evaluate the influence of meal nutritional composition on interstitial fluid glucose (IFG) profiles and symptom profile after Roux-en-Y gastric bypass (RYGB).
Seventeen subjects previously submitted to RYGB were allocated into two groups of symptomatic (n = 9) or control individuals (n = 8), according to spontaneous report of symptoms suggestive of hypoglycemia. Subjects were provided with a food and symptom diary (FSD) to record dietary intake and symptoms experienced, while using a flash glucose monitoring (FGM) system for 14 days.
Postprandial symptom reports occurred in 70.5% of subjects (88.9% vs 50.0%, p = 0.0790, symptomatic vs control), although symptoms with concurrent IFG < 54 mg/dL and within 54 to 69 mg/dL were only observed in 31.9% and 4.8% of the events in the symptomatic vs control group, respectively (p = 0.0110). Daily glucose profiles, total energy, and macronutrients intake were not significantly different between the groups. However, nutritional composition of meals preceding reported symptoms had lower protein (3.2 g ± 1.0 g vs 7.7 g ± 0.5 g, p = 0.0286) or higher sugar (11.6 g ± 2.4 g vs 4.3 g ± 0.9 g, p = 0.0333) content.
Postprandial symptoms are often in patients after RYGB. Concurrent hypoglycemia only occurs in up to a third of the symptomatic episodes being more frequent in patients that spontaneously reported complaints. Hypoglycemia is more likely to be triggered by meals with a low protein or high sugar content. These findings highlight the putative role of meal composition in eliciting PBH and reinforce the need to refine nutritional intervention.
背景/目的：人们已经认识到需要改进减重手术后低血糖（PBH）的诊断和临床管理。我们的目的是评估 Roux-en-Y 胃旁路术（RYGB）后饮食营养成分对间质液葡萄糖（IFG）谱和症状谱的影响。
17 名先前接受过 RYGB 的受试者根据低血糖症状的自发报告，分为有症状组（n = 9）或对照组（n = 8）。受试者被提供饮食和症状日记（FSD）记录饮食摄入和经历的症状，同时使用即时葡萄糖监测（FGM）系统 14 天。
70.5%的受试者出现餐后症状报告（有症状组 88.9%，对照组 50.0%，p = 0.0790），但只有 31.9%和 4.8%的事件同时伴有 IFG<54mg/dL 和 54-69mg/dL 的症状在有症状组和对照组中观察到（p = 0.0110）。两组的日常血糖谱、总能量和宏量营养素摄入没有显著差异。然而，报告症状前的膳食营养成分中，蛋白质含量较低（3.2g ± 1.0g 比 7.7g ± 0.5g，p = 0.0286）或糖含量较高（11.6g ± 2.4g 比 4.3g ± 0.9g，p = 0.0333）。
RYGB 后患者常出现餐后症状。只有三分之一的有症状发作同时发生低血糖，自发性报告的患者中更常见。低血糖更可能由低蛋白或高糖含量的膳食引发。这些发现突出了膳食成分在引发 PBH 中的潜在作用，并强调需要改进营养干预。
