POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE

Detalhes bibliográficos
Autor(a) principal: Lobato, Carolina B.
Data de Publicação: 2021
Outros Autores: Monteiro, Mariana P., Guimarães, Marta
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.34635/rpc.884
Resumo: Approaching the patient presenting symptoms compatible with post-bariatric hypoglycaemia (PBH) is a major clinical challenge for surgeons, endocrinologists, nutritionists, and primary care physicians. Raising the hypothesis of PBH as differential diagnosis requires a high degree of suspicion, since patient clinical features at presentation are highly unspecific and overlap with those of dumping syndrome, which is highly prevalent in this population. The temporal relationship between food intake and hypoglycaemia poses an additional challenge for laboratorial documentation. PBH aetiology is poorly understood and appears to be multifactorial, which limits the possibility of targeting treatment interventions. By means of this review, we aim to summarize the best evidence available regarding PBH pathophysiology, diagnosis and treatment. A diagnosis and therapeutic algorithm for patient approach, easy to implement at both primary care and tertiary hospitalary centres settings is herein proposed.
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spelling POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICEHIPOGLICEMIA APÓS CIRURGIA BARIÁTRICA: DA EVIDÊNCIA CIENTÍFICA À PRÁTICA CLÍNICAApproaching the patient presenting symptoms compatible with post-bariatric hypoglycaemia (PBH) is a major clinical challenge for surgeons, endocrinologists, nutritionists, and primary care physicians. Raising the hypothesis of PBH as differential diagnosis requires a high degree of suspicion, since patient clinical features at presentation are highly unspecific and overlap with those of dumping syndrome, which is highly prevalent in this population. The temporal relationship between food intake and hypoglycaemia poses an additional challenge for laboratorial documentation. PBH aetiology is poorly understood and appears to be multifactorial, which limits the possibility of targeting treatment interventions. By means of this review, we aim to summarize the best evidence available regarding PBH pathophysiology, diagnosis and treatment. A diagnosis and therapeutic algorithm for patient approach, easy to implement at both primary care and tertiary hospitalary centres settings is herein proposed.A abordagem ao doente com apresentação clínica compatível com hipoglicemia pós-cirurgia bariátrica (HPB) é um desafio clínico com que se depararam os cirurgiões, endocrinologistas, nutricionistas e médicos de família que acompanham estes doentes. Colocar este diagnóstico diferencial como hipótese implica um elevado grau de suspeição dado que a clínica é altamente inespecífica e sobreponível à da síndrome de dumping, muito prevalente nesta população. A relação das hipoglicemias com a ingestão alimentar dificulta também a sua documentação analítica. A sua etiologia é mal-esclarecida e aparentemente multifatorial, o que limita a possibilidade de abordagem terapêutica dirigida. Com a presente revisão, pretendemos compilar a melhor evidência disponível sobre a fisiopatologia, diagnóstico e tratamento da HPB e propor um algoritmo para a investigação diagnóstica e abordagem terapêutica destes doentes, com aplicabilidade nos cuidados de saúde primários e em contexto hospitalar.Sociedade Portuguesa de Cirurgia2021-08-09info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.34635/rpc.884https://doi.org/10.34635/rpc.884Revista Portuguesa de Cirurgia; No 50 (2021): Number 50 - March 2021; 33-42Revista Portuguesa de Cirurgia; No 50 (2021): Number 50 - March 2021; 33-422183-11651646-6918reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://revista.spcir.com/index.php/spcir/article/view/884https://revista.spcir.com/index.php/spcir/article/view/884/601Copyright (c) 2021 Revista Portuguesa de Cirurgiainfo:eu-repo/semantics/openAccessLobato, Carolina B.Monteiro, Mariana P.Guimarães, Marta2024-03-14T22:05:37Zoai:revista.spcir.com:article/884Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T04:00:56.267088Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
HIPOGLICEMIA APÓS CIRURGIA BARIÁTRICA: DA EVIDÊNCIA CIENTÍFICA À PRÁTICA CLÍNICA
title POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
spellingShingle POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
Lobato, Carolina B.
title_short POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
title_full POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
title_fullStr POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
title_full_unstemmed POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
title_sort POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
author Lobato, Carolina B.
author_facet Lobato, Carolina B.
Monteiro, Mariana P.
Guimarães, Marta
author_role author
author2 Monteiro, Mariana P.
Guimarães, Marta
author2_role author
author
dc.contributor.author.fl_str_mv Lobato, Carolina B.
Monteiro, Mariana P.
Guimarães, Marta
description Approaching the patient presenting symptoms compatible with post-bariatric hypoglycaemia (PBH) is a major clinical challenge for surgeons, endocrinologists, nutritionists, and primary care physicians. Raising the hypothesis of PBH as differential diagnosis requires a high degree of suspicion, since patient clinical features at presentation are highly unspecific and overlap with those of dumping syndrome, which is highly prevalent in this population. The temporal relationship between food intake and hypoglycaemia poses an additional challenge for laboratorial documentation. PBH aetiology is poorly understood and appears to be multifactorial, which limits the possibility of targeting treatment interventions. By means of this review, we aim to summarize the best evidence available regarding PBH pathophysiology, diagnosis and treatment. A diagnosis and therapeutic algorithm for patient approach, easy to implement at both primary care and tertiary hospitalary centres settings is herein proposed.
publishDate 2021
dc.date.none.fl_str_mv 2021-08-09
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.34635/rpc.884
https://doi.org/10.34635/rpc.884
url https://doi.org/10.34635/rpc.884
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://revista.spcir.com/index.php/spcir/article/view/884
https://revista.spcir.com/index.php/spcir/article/view/884/601
dc.rights.driver.fl_str_mv Copyright (c) 2021 Revista Portuguesa de Cirurgia
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Copyright (c) 2021 Revista Portuguesa de Cirurgia
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Cirurgia
publisher.none.fl_str_mv Sociedade Portuguesa de Cirurgia
dc.source.none.fl_str_mv Revista Portuguesa de Cirurgia; No 50 (2021): Number 50 - March 2021; 33-42
Revista Portuguesa de Cirurgia; No 50 (2021): Number 50 - March 2021; 33-42
2183-1165
1646-6918
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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