(PhysOrg.com) -- People with type 2 diabetes who have gastric bypass surgery often leave the hospital without the need for previously prescribed diabetes medications.
Researchers and doctors believe this health benefit is related to changes in the body’s circulating hormones—particularly an increase of insulin secretion. Insulin is the hormone that controls the level of glucose (sugar) in the blood.
Marzieh Salehi, MD, a diabetologist with UC Health University of Cincinnati Physicians whose research is focused on the effect of weight-loss surgery on glucose metabolism, cautions that although there can be huge benefits for diabetic patients who undergo gastric bypass surgery, a group of patients experience severely low levels of blood sugar (hypoglycemia)—especially following a meal and typically several years after surgery. Symptoms of hypoglycemia often aren’t recognized until they become debilitating or life-threatening.
Salehi says that many patients with type 2 diabetes who qualify for gastric bypass surgery rely on anti-diabetic medications like insulin injections to regulate glucose in the body. These same patients often leave the hospital following surgery with normal glucose control without taking any medications.
“It’s possible,” says Salehi, “that gastric bypass increases gut hormone secretion or nervous system activity, which in turn increases insulin secretion and improves glucose metabolism in a majority of patients after surgery.
“However,” she adds, “there is a population of gastric bypass patients who, following surgery, develop high levels of endogenous insulin secretion, resulting in dangerously low glucose levels, or hypoglycemia. These glucose abnormalities due to too much insulin secretion represent an extreme effect of gastric bypass surgery.”
Salehi, who sees weight-loss surgery patients with glucose abnormalities at the UC Health Diabetes Center, says symptoms of hypoglycemia include shakiness, sweating, dizziness, light-headedness, weakness, confusion and difficulty speaking. More severe symptoms include seizure and cognitive abnormalities. Hypoglycemia can be life-threatening without proper monitoring or treatment.
“If hypoglycemia goes unnoticed, the body can become accustomed to low sugar and patients can then lose their awareness to low sugar. It is essential to seek help if any of these symptoms develop after gastric bypass surgery.”