Postbariatric Surgery Hypoglycemia and Nutritional Deficiencies: Long-Term Follow-Up

Abstract

Background:

The aim was to assess the long-term impact of laparoscopic sleeve gastrectomy (LSG) on weight loss, postload hypoglycemia, and nutritional status of 25-OH-vitamin D, cyanocobalamin, albumin, creatinine, ferritin, and hemoglobin.

Methods:

A prospective, longitudinal analysis of collected data from 60 sleeve gastrectomy patients was performed on a 5-year follow-up period.

Results:

Therapeutic success rate (excess body mass index loss ≥60%) was 80% at 5 years. The prevalence of postload hypoglycemia increased progressively, reaching a maximum at 1 year (20.3%) and then drop out to 0% at 5 years postoperatively. Glycemic profile and insulin resistance improved significantly from the 1st month postoperatively, remaining stable thereafter, whereas the C peptide had a decreasing trend throughout the study period. Prevalence of nutritional deficiencies at baseline, 1 month, 3 months, 1 year, and 5 years postsurgery were specifically for cyanocobalamin (0%, 3.3%, 15.5%, 27.1%, and 30.0%), vitamin D (21.7%, 48.3%, 63.8%, 76.3%, and 85%), and albumin (0%, 16.7%, 1.7%, 1.7%, and 11.7%, respectively). Ferritin and hemoglobin levels showed a significant drop in the 1st month postoperative and remain stable afterward, whereas creatinine decreased significantly after the 1st year postoperative in comparison with preoperative.

Conclusions:

LSG was effective in terms of weight loss, insulin sensitivity, and glycemic profile improvement, but with the risk of nutritional deficiencies and postload hypoglycemia.