Letter to the Editor
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World J Diabetes. Mar 15, 2022; 13(3): 278-281
Published online Mar 15, 2022. doi: 10.4239/wjd.v13.i3.278
Beyond diabetes remission a step further: Post bariatric surgery hypoglycemia
Devraj Lath, Kripa Elizabeth Cherian, Thomas Vizhalil Paul, Nitin Kapoor
Devraj Lath, Kripa Elizabeth Cherian, Thomas Vizhalil Paul, Nitin Kapoor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore 632004, Tamil Nadu, India
Nitin Kapoor, Non Communicable Disease Unit, Nossal Institute of Global Health, Melbourne 3053, Victoria, Australia
Nitin Kapoor, The Baker Heart and Diabetes Institute, Melbourne 3004, Victoria, Australia
Author contributions: Kapoor N conceived of the presented idea and provided critical feedback to the final manuscript; Lath D wrote the manuscript; Cherian K and Paul TV approved the main conceptual ideas and proof outline; all authors provided final edits and approved the manuscript.
Conflict-of-interest statement: No conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Nitin Kapoor, MD, PhD, Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Main Block Ida Scudder Road, Vellore 632004, Tamil Nadu, India. nitin.endocrine@gmail.com
Received: September 24, 2021
Peer-review started: September 24, 2021
First decision: January 12, 2022
Revised: January 21, 2022
Accepted: February 23, 2022
Article in press: February 23, 2022
Published online: March 15, 2022
Processing time: 171 Days and 21.5 Hours
Core Tip

Core Tip: Postbariatric hypoglycemia is an uncommon complication presenting months to years after bariatric surgery (mostly in Roux-en-Y gastric bypasses) as postprandial hyperinsulinemic hypoglycaemia occurring 1-3 h after meals, and the associated neuroglycopenic symptoms can be incapacitating. Medical nutrition therapy forms the foundation of management, with pharmacotherapy and surgical interventions available for those who do not respond. An increased understanding of the implicated mechanisms has led to the development of targeted agents like avexitide, which has demonstrated good efficacy in a Phase 2 clinical trial (PREVENT) recently.