#1689901 A Challenging Case of Hyperinsulinemic Hypoglycemia after Roux-en-Y Gastric Bypass Complicated during Pregnancy

Postprandial Hyperinsulinemic hypoglycemia is a rare complication of Roux-en-Y gastric bypass, occurring in approximately 0.1 to 0.3 % of patients. This usually presents with adrenergic and neuroglycopenic symptoms one to three hours after ingesting a carbohydrate-rich meal. Its underlying pathophysiology remains poorly understood, but it is believed to involve increase in incretin serum concentration. The management primarily consists of dietary modifications consisting in limiting simple carbohydrates and replacing them with complex carbohydrates, fiber, and increased protein intake.