A woman who had gastric bypass surgery and has cancer spread to the liver experienced low blood sugar after meals, which coincided with high levels of insulin and c-peptide, suggesting her body was...
Mechanism
Synthesis from 1 study
After stomach surgery, food rushes into the intestines and tricks the body into releasing too much insulin. This insulin pulls sugar out of the blood too quickly. Because the liver is damaged by cancer, it can't release sugar back in time to fix the drop, so blood sugar falls dangerously low.
Most probable mechanism
After stomach surgery, food moves too quickly into the small intestine, causing the body to release too much insulin. This insulin pulls sugar out of the blood too fast, and because the liver is damaged by cancer, it can't release sugar back into the blood to fix the low levels, leading to dangerous drops in blood sugar.
Roux-en-Y gastric bypass alters gastrointestinal anatomy, causing rapid delivery of ingested carbohydrates to the proximal small intestine.
Rapid glucose absorption stimulates L-cells to secrete GLP-1 and GIP, leading to exaggerated incretin effect.
Excessive incretin signaling overstimulates pancreatic beta cells, causing disproportionate insulin secretion.
Excess insulin drives glucose into peripheral tissues and suppresses hepatic gluconeogenesis and glycogenolysis.
Liver metastases impair hepatic glycogen storage and glucose production capacity, reducing counterregulatory response to hypoglycemia.
Evidence from Studies
Supporting (1)
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Contradicting (0)
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