Hipoglicemia após cirurgia bariátrica: da evidência científica à prática clínica

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.