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Open AccessCase Report

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

1
Department of Clinical Medicine and Surgery, Federico II University, 80131 Naples, Italy
2
Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University, 80131 Naples, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2018, 10(6), 670; https://doi.org/10.3390/nu10060670
Received: 23 April 2018 / Revised: 18 May 2018 / Accepted: 23 May 2018 / Published: 25 May 2018
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. View Full-Text
Keywords: post-bariatric hypoglycemia; cornstarch; gastric bypass; nutrition post-bariatric hypoglycemia; cornstarch; gastric bypass; nutrition
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Lembo, E.; Lupoli, R.; Ciciola, P.; Creanza, A.; Silvestri, E.; Saldalamacchia, G.; Capaldo, B. Implementation of Low Glycemic Index Diet Together with Cornstarch in Post-Gastric Bypass Hypoglycemia: Two Case Reports. Nutrients 2018, 10, 670.

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