The role of gastro-entero-pancreatic hormones on hypoglycaemia following RYGB and in patients with pancreatogenic diabetes
File(s)
Author(s)
Ibiyemi, Ilesanmi
Type
Thesis
Abstract
Hypoglycaemia is the main limitation of the intensive treatment of diabetes. Bariatric surgery is the most effective treatment for type 2 diabetes; however, a small proportion of patients develop symptoms of hypoglycaemia following bariatric surgery. The pathophysiology of this condition, known as Post-Bariatric Hypoglycaemia (PBH), has been debated in the literature. Firstly, I investigate the incidence of hypoglycaemia using continuous glucose monitoring (CGM) and meal provocation tests prospectively in asymptomatic patients who have undergone RYGB. I compare their CGM metrics and meal provocation tests to patients presenting with PBH. There is currently no licensed pharmacotherapy to treat post-bariatric hypoglycaemia, so dietary measures are the first line of treatment for PBH. The mechanism by which dietary modification affects glucose homeostasis is poorly understood in this group of patients. I explored whether altering macronutrient composition could ameliorate hypoglycaemia by modifying gastro-pancreatic hormones.
Version
Open Access
Date Issued
2024-04-08
Date Awarded
2025-09-01
Copyright Statement
Attribution-NonCommercial 4.0 International Licence (CC BY-NC)
License URL
Advisor
Tan, Tricia
Cegla, Jaimini
Publisher Department
Department of Metabolism, Digestion and Reproduction
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)