Mechanisms for hypoglycemia following gastric bypass surgery
• Dumping syndrome occurs following gastric bypass patients after ingestions of simple carbohydrates. Rapid emptying of food into the small bowel results in fluid shifts and insulin release, resulting in hypotension, diarrhea, tachycardia, and hypoglycemia. Treatment entails small frequent meals and avoidance of simple carbohydrates.
• Islet cell hyperplasia may develop following gastric bypass, or an underlying defect may be unmasked. Patients are at risk for nesidioblastosis and even insulinoma in rare cases.