Key result
Diet and supplementation resolve severe anemia and hypoglycemia 10 years post-Roux-en-Y gastric bypass.
Why the study?
Postprandial hypoglycemia is a rare complication after Roux-en-Y gastric bypass and its underlying pathophysiology remains to be fully understood.
Case Report (n=1)
Dietary adjustments and IV iron/IM B12 supplementation successfully managed postprandial hypoglycemia and severe anemia in a patient 10 years post-RYGB, enabling the resumption of necessary anticoagulation.
Postprandial hypoglycemia is a rare complication after Roux-en-Y gastric bypass (RYGB). The underlying pathophysiology remains to be fully understood. We present a case of a 49-year-old woman with a past medical history of mesenteric thrombosis due to prothrombin-related thrombophilia, which culminated in RYGB 10 years prior to presentation. The patient had been given anticoagulation treatment for several years, which she abandoned one year prior to presentation. She presented to our consultation with episodes of postprandial hypoglycemia and severe anemia due to iron and vitamin B12 deficiencies. Dietary adjustments were set in place to prevent hypoglycemia and neuroglycopenic symptoms. Intravenous iron and intramuscular vitamin B12 supplementation led to full recovery of hemoglobin levels, allowing restart of oral anticoagulation to prevent recurrence of thrombotic events.
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Coelho et al. (2022) conducted a case report in Postprandial hypoglycemia and severe anemia (n=1). Roux-en-Y gastric bypass was evaluated on Development of postprandial hypoglycemia and anemia. Roux-en-Y gastric bypass resulted in severe iron and vitamin B12 deficiency anemia and postprandial hypoglycemia 10 years post-surgery, which resolved with supplementation and dietary modifications.
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