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Hypoglycemia during oral glucose tolerance test among post-bariatric surgery pregnant patients.

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eMediNexus    27 January 2018

A recent study published in Surgery for Obesity and Related Diseases aimed to investigate the incidence of hypoglycemia among pregnant women post-bariatric surgery (BS), evaluated for gestational diabetes. This study investigated oral glucose tolerance test (OGTT) results and pregnancy outcomes in 119 pregnant women who underwent 3 types of bariatric procedures before pregnancy; maternal and fetal outcomes were assessed. The results revealed that among the participants 55 underwent laparoscopic sleeve gastrectomy; 34 laparoscopic adjustable gastric banding; and 30 laparoscopic Roux-en-Y gastric bypass surgery. Hypoglycemia was detected in 49.6% of the participants during the OGTT. While the lowest plasma glucose levels occurred 2 hours after glucose ingestion in 42.4% and after 3 hours in 57.6% subjects, with a median value of 47 mg/dL. Moreover, the risk of hypoglycemia was found to be higher in women with prior laparoscopic Roux-en-Y gastric bypass surgery, than among those with prior laparoscopic sleeve gastrectomy or laparoscopic adjustable gastric banding. Additionally, time from surgery to conception was significantly shorter among women with evidence of hypoglycemia during OGTT. Furthermore, when compared to patients without evidence of hypoglycemia, patients who experienced hypoglycemia had lower rates of gestational diabetes, but higher proportions of low birth weight and small for gestational age infants. From the findings, it was suggested that since hypoglycemia is common during OGTT among post-BS pregnant women, other diagnostic methods should be considered for the evaluation of gestational diabetes. It was stated that the association found between hypoglycemia and poor fetal growth warrants investigation as to whether interventions to prevent hypoglycemia could improve fetal outcomes.

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