Imperial College London
Alternate

ProfessorCarelLe Roux

Faculty of Medicine, Department of Metabolism, Digestion and Reproduction

Visiting Professor
 
 
 
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Contact

 

+44 (0)7970 719 453c.leroux

 
 
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Location

 

08, east wingCharing Cross HospitalCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Qvigstad:2016:10.1016/j.ijscr.2016.02.033,
author = {Qvigstad, E and Gulseth, HL and Risstad, H and le, Roux CW and Berg, TJ and Mala, T and Kristinsson, JA},
doi = {10.1016/j.ijscr.2016.02.033},
journal = {International Journal of Surgery Case Reports},
pages = {91--94},
title = {A novel technique of Roux-en-Y gastric bypass reversal for postprandial hyperinsulinemic hypoglycaemia: a case report},
url = {http://dx.doi.org/10.1016/j.ijscr.2016.02.033},
volume = {21},
year = {2016}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: We describe an evaluation of the effects of partial Roux-en-Y gastric bypass (RYGB) reversal on postprandial hyperinsulinaemic hypoglycaemia, insulin and GLP-1 levels. CASE SUMMARY: A 37 year old man was admitted with neuroglycopenia (plasma-glucose 1.6mmol/l) 18 months after RYGB, with normal 72h fasting test and abdominal CT. Despite dietary modifications and medical treatment, the hypoglycaemic episodes escalated in frequency. Feeding by a gastrostomy tube positioned in the gastric remnant did not prevent severe episodes of hypoglycaemia. A modified reversal of the RYGB was performed. Mixed meal tests were done perorally (PO), through the gastrostomy tube 1 (GT1), 4 weeks (GT2) after placement and 4 weeks after reversal (POr), with assessment of glucose, insulin and GLP-1 levels. RESULTS: Plasma-glucose increased to a maximum of 9.6, 5.4, 6.5 and 5.8mmol/l at the PO, GT1, GT2 and POr tests respectively. The corresponding insulin levels were 2939, 731, 725 and 463pmol/l. A decrease of plasma-glucose followed: 2.2, 3.0, 3.9 and 2.9mmol/l respectively and insulin levels were suppressed at 150min: 45, 22, 21 and 14pmol/l, respectively. GLP-1 levels increased in the PO test (60min: 122pmol/l, 21 fold of basal), but was attenuated in the two latter tests (12-23pmol/l at 60min). CONCLUSIONS: Reduction of plasma-glucose, insulin and GLP-1 excursions and symptoms were seen after gastric tube placement and partial RYGB reversal. This attenuation of GLP-1 response to feeding could reflect an adaptation to nutrients.
AU  - Qvigstad,E
AU  - Gulseth,HL
AU  - Risstad,H
AU  - le,Roux CW
AU  - Berg,TJ
AU  - Mala,T
AU  - Kristinsson,JA
DO  - 10.1016/j.ijscr.2016.02.033
EP  - 94
PY  - 2016///
SN  - 2210-2612
SP  - 91
TI  - A novel technique of Roux-en-Y gastric bypass reversal for postprandial hyperinsulinemic hypoglycaemia: a case report
T2  - International Journal of Surgery Case Reports
UR  - http://dx.doi.org/10.1016/j.ijscr.2016.02.033
UR  - http://www.ncbi.nlm.nih.gov/pubmed/26957187
UR  - http://hdl.handle.net/10044/1/30971
VL  - 21
ER  -
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