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February 17, 2009 06:06 PM

What are the risks to the pancreas after gastric bypass surgery?

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February 17, 2009 07:09 PM
I'll start this out with saying I'm no where near an expert nor do I have any medical training. But, from what I've read, there seems to be a problem with the Pancreas not adjusting to the new levels of insulin levels needed to regulate sugar. As your body digests food, simple sugars enter the blood and provide you with energy. If this sugar gets too high, it can cause complications, too low, and you spiral in energy until you get complications from this. It's the same effect as diabetes. The complication you refer to is that the pancreas still puts out the old amount of insulin which is FAR too much for the new amount of sugar in their system. This causes a sever drop in blood sugar(insulin is sugar's natural anti-agent in the body), and can result in dizziness, blackouts, coma, or even death. More information on the effects of insulin/sugar can be found by reading up on diabetes. This appears to be treated by partial/full removal of the pancreas(which makes the person permanently diabetic), or in some cases the killing of a specific number of Islets (see Islets of Langerhans for more info on what these do), which are what secrete the insulin

http://www.ncbi.nlm.nih.gov/pubmed/16034010
"We describe six patients (five women and one man; median age, 47 years; range, 39 to 54) with postprandial symptoms of neuroglycopenia owing to endogenous hyperinsulinemic hypoglycemia after Roux-en-Y gastric bypass surgery. Except for equivocal evidence in one patient, there was no radiologic evidence of insulinoma. Selective arterial calcium-stimulation tests, positive in each patient, were used to guide partial pancreatectomy. Nesidioblastosis was identified in resected specimens from each patient, and multiple insulinomas were identified in one. Hypoglycemic symptoms diminished postoperatively. We speculate that hyperfunction of pancreatic islets did not lead to obesity but that beta-cell trophic factors may have increased as a result of gastric bypass."

http://www.news-medical.net/?id=13727
"The paper follows on the heels of a Mayo Clinic report on six similar case studies published in July in the New England Journal of Medicine. About 160,000 people undergo gastric bypass surgery every year.

The study details the history of three patients, who did not have diabetes, who suffered such severe hypoglycemia following meals that they became confused and sometimes blacked out, in two cases causing automobile collisions. The immediate cause of hypoglycemia was exceptionally high levels of insulin following meals. All three patients in the collaborative study failed to respond to medication, and ultimately required partial or complete removal of the pancreas, the major source of insulin, to prevent dangerous declines in blood glucose. "
Source(s):
Bio 101 and a LOT of experience with diabetes in the family



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