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Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports

Post-bariatric hypoglycemia (PBH) is an increasingly recognized long-term complication of bariatric surgery. The nutritional treatment of PBH includes a high-fiber diet and the restriction of soluble and high-glycemic index carbohydrates; however, these measures are not always enough to prevent hypo...

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Autores principales: Lembo, Erminia, Lupoli, Roberta, Ciciola, Paola, Creanza, Annalisa, Silvestri, Eufemia, Saldalamacchia, Gennaro, Capaldo, Brunella
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024813/
https://www.ncbi.nlm.nih.gov/pubmed/29799438
http://dx.doi.org/10.3390/nu10060670
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author Lembo, Erminia
Lupoli, Roberta
Ciciola, Paola
Creanza, Annalisa
Silvestri, Eufemia
Saldalamacchia, Gennaro
Capaldo, Brunella
author_facet Lembo, Erminia
Lupoli, Roberta
Ciciola, Paola
Creanza, Annalisa
Silvestri, Eufemia
Saldalamacchia, Gennaro
Capaldo, Brunella
author_sort Lembo, Erminia
collection PubMed
description Post-bariatric hypoglycemia (PBH) is an increasingly recognized long-term complication of bariatric surgery. The nutritional treatment of PBH includes a high-fiber diet and the restriction of soluble and high-glycemic index carbohydrates; however, these measures are not always enough to prevent hypoglycemia. We evaluated the efficacy of uncooked cornstarch, a low-glycemic index carbohydrate characterized by slow intestinal degradation and absorption, in addition to a high-fiber diet, for the treatment of PBH. We report the cases of two young women suffering from severe postprandial and fasting hypoglycemia following Roux-en-Y gastric bypass (RYGB). The patients underwent Continuous Glucose Monitoring (CGM) before and 12–16 weeks after the administration of uncooked cornstarch (respectively 1.25 g/kg b.w. and 1.8 g/kg b.w.) in addition to a high-fiber diet. In both patients, CGM showed more stable glucose levels throughout monitoring, a remarkable reduction of the time spent in hypoglycemia (<55 mg/dL) both during the day (−11% for both patients) and the night (−22% and −32%), and the improvement of all glycemic variability indexes. Our report, within the limit of only two cases, suggests that the implementation of a dietary intervention through the addition of uncooked cornstarch reduces daily glycemic fluctuations and hypoglycemic episodes in patients with PBH.
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spelling pubmed-60248132018-07-08 Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports Lembo, Erminia Lupoli, Roberta Ciciola, Paola Creanza, Annalisa Silvestri, Eufemia Saldalamacchia, Gennaro Capaldo, Brunella Nutrients Case Report Post-bariatric hypoglycemia (PBH) is an increasingly recognized long-term complication of bariatric surgery. The nutritional treatment of PBH includes a high-fiber diet and the restriction of soluble and high-glycemic index carbohydrates; however, these measures are not always enough to prevent hypoglycemia. We evaluated the efficacy of uncooked cornstarch, a low-glycemic index carbohydrate characterized by slow intestinal degradation and absorption, in addition to a high-fiber diet, for the treatment of PBH. We report the cases of two young women suffering from severe postprandial and fasting hypoglycemia following Roux-en-Y gastric bypass (RYGB). The patients underwent Continuous Glucose Monitoring (CGM) before and 12–16 weeks after the administration of uncooked cornstarch (respectively 1.25 g/kg b.w. and 1.8 g/kg b.w.) in addition to a high-fiber diet. In both patients, CGM showed more stable glucose levels throughout monitoring, a remarkable reduction of the time spent in hypoglycemia (<55 mg/dL) both during the day (−11% for both patients) and the night (−22% and −32%), and the improvement of all glycemic variability indexes. Our report, within the limit of only two cases, suggests that the implementation of a dietary intervention through the addition of uncooked cornstarch reduces daily glycemic fluctuations and hypoglycemic episodes in patients with PBH. MDPI 2018-05-25 /pmc/articles/PMC6024813/ /pubmed/29799438 http://dx.doi.org/10.3390/nu10060670 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Lembo, Erminia
Lupoli, Roberta
Ciciola, Paola
Creanza, Annalisa
Silvestri, Eufemia
Saldalamacchia, Gennaro
Capaldo, Brunella
Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
title Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
title_full Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
title_fullStr Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
title_full_unstemmed Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
title_short Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports
title_sort implementation of low glycemic index diet together with cornstarch in post-gastric bypass hypoglycemia: two case reports
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6024813/
https://www.ncbi.nlm.nih.gov/pubmed/29799438
http://dx.doi.org/10.3390/nu10060670
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