Incidence of Hypoglycemia After Gastric Bypass vs Sleeve Gastrectomy: A Randomized Trial.

摘要: Context We compared the incidence of hypoglycemia after Roux-en-Y gastric bypass (RYGB) vs sleeve gastrectomy (SG). Design, Setting, and Main Outcome Measures Randomized, open-label trial conducted at outpatient obesity clinic in a university hospital Rome, Italy. The primary aim was reactive (<3.1 mmol/L 75-g oral glucose load) 1 year surgery. Secondary aims were under everyday life conditions, insulin sensitivity, secretion, lipid profile. Results Of 175 eligible patients, 120 randomized 1:1 to RYGB or SG; 117 (93%) completed 12-month follow-up. Reactive detected 14% 29% SG patients (P = 0.079), respectively, with effect treatment multivariate analysis significant P 0.018. Daily hypoglycemic episodes during continuous monitoring did not differ between groups 0.75). Four 59 subjects (6.8%) had 3 hospitalizations for symptomatic 0 SG. static β-cell sensitivity index increased both treatments < 0.001), but dynamic significantly 0.008) decreased 0.004 time × interaction). Whole-body about 10-fold groups. Conclusions show that is no less common safer option than RYGB, associated more severe episodes. This likely due lack improvement changes circulating which determines an inappropriately high secretion.