Avoiding Hypoglycemia After Bariatric Surgery

26 jan 2009--A review in Annals of Internal Medicine suggests that clinicians caring for diabetic patients after bariatric surgery should be aware of the changes the procedures cause to patients' glucose metabolism.

The analysts remind clinicians that about a third of patients undergoing bariatric surgery have type 2 diabetes and that the condition resolves for over 80% undergoing bypass procedures and in about two thirds of those having restrictive procedures.

They advise that "patients may require only long-acting basal insulin in the immediate postoperative period, with rapid-acting insulin for correction of hyperglycemia as necessary." When patients resume eating, the authors advise use of rapid-acting insulin after prandial coverage because "its short action reduces the risk for dose-stacking and subsequent hypoglycemia."

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Annals of Internal Medicine article (Free abstract; full text requires subscription)