ECE2017 Eposter Presentations: Diabetes, Obesity and Metabolism Obesity (81 abstracts)
Late dumping syndrome in pregnant women after ROUX-EN-Y gastric bypass (RYGB) surgery
Lucía Vera Pacheco 1 , María Teresa Gallego García 2 , Cristina Del Peso Gilsanz 2 , Lorena Rentero Redondo 2 , Carles Iniesta Navalón 2 , Noelia Victoria García-Talavera Espín 2 , M a Bienvenida García-Talavera Espín , Manuel Romero Muñoz 1 & Amparo Meoro Avilés 2
1University Hospital Rafael Mendez, Lorca,Murcia, Spain; 2University Hospital Reina Sofía, Murcia, Spain.
Introduction: Dumping syndromes are common after bariatric surgery and can present diagnostic and therapeutic challenges in pregnancy.
Case report: A 23-year-old female who underwent a RYGB surgery because of morbid obesity in 2013. She had no medical history of diabetes nor any other comorbidity related to obesity. Two years later, her weight had reduced from 128 to 76 kg and also her body mass index (BMI) from 43.8 to 26 kg/m2. She was treated with multivitamins, iron vitamin B12 and calcium. She remained clinically asymptomatic. In 2016, she got pregnant and on the 24th gestational week she checked herself post prandial capillary blood glucose (CBG) that confirmed hypoglycemia, with glucose levels from 55 mg/dl to 30 mg/dl, accompanied by clinical intense asthenia. Fasting plasma glucose was 71 mg/dl and insulin 5 mIU / ml (2.6–24.9). Dietary modification with frequent intakes every 3 hours, with low glycaemic index food and avoidance of physical activity immediately after oral intake were recommended. At the beginning, the episodes were reduced, but on the 35th gestational week hypoglycemia episodes had increased in severity and frequency, raising concerns of the risk of maternal neuroglycopenia and fetal hypoglycemia, that’s why it was decided to treated with Diabetes-specific Oral Nutritional Supplement (low in carbohydrates with no added sucrose, high in protein and contains soluble fiber) twice a day between the main meals. Finally, on the 39th gestational week an induced birth was planned of a healthy 31oo-g infant, with a nearly complete remission of the dumping syndrome after giving birth.
Conclusions: Dumping syndromes in pregnant women that have gone through a RYGB surgery need to be distinguished from common symptoms of a normal pregnancy. Its therapeutic use gets more difficult, because it was restricted to dietetic modifications and not having medicines that have indication by FDA during pregnancy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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