POST-BARIATRIC HYPOGLYCAEMIA: FROM SCIENTIFIC EVIDENCE TO CLINICAL PRACTICE
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , |
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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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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1799138183376535552 |