A friend told me about a side effect of bariatric surgery (Post-gastric bypass hypoglycemia: A serious complication of bariatric surgery).
One long-term risk is the development of postprandial hypoglycemia. This phenomenon was first described in the literature in 2005. The prevalence still remains unknown, but as endocrinologists we will undoubtedly be seeing more of these patients. Hypoglycemia typically does not present until 2 to 3 years after gastric bypass surgery.
These hypoglycemic episodes are characterized by low blood sugars that occur 2 to 3 hours after a meal. Fasting hypoglycemia is typically not seen. The etiology seems to be excessive insulin secretion in response to the meal. It is well documented that patients are more insulin sensitive after gastric bypass surgery, but the pathophysiology of these specific patients who develop hypoglycemia remains unclear.
It is hypothesized that it may be related to elevations in the incretin hormones glucagon-like peptide 1 and gastric inhibitory polypeptide, and their ability to stimulate additional insulin secretion. It has also been debated whether increased beta-cell mass may lead to excessive insulin secretion.
The article concentrated on the reaction to carbohydrates.
In Part 2 I will start to look at possible ways to compensate for this issue from a Low Carb diet perspective.