In people who have had Roux-en-Y gastric bypass surgery and have cancer spread to the liver, low levels of stored glucose in the liver are linked to episodes of low blood sugar after meals and during...
Mechanism
Synthesis from 1 study
After stomach surgery, too much insulin is released after eating, pulling sugar out of the blood. Normally, the liver would release stored sugar to balance this, but cancer in the liver damages that ability. Without enough stored sugar to release, blood sugar drops too low and stays low, especially...
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 and into tissues. Normally, the liver would release stored sugar to keep blood sugar from dropping too low, but cancer in the liver damages its ability to store and release sugar. Without this backup, blood sugar crashes, especially after meals or overnight.
Roux-en-Y gastric bypass alters gastrointestinal anatomy, causing rapid delivery of carbohydrates to the proximal small intestine.
Rapid glucose absorption triggers exaggerated secretion of incretin hormones (GLP-1 and GIP), leading to overstimulation of pancreatic beta cells.
Excessive insulin secretion drives glucose into peripheral tissues and suppresses hepatic glucose production.
Liver metastases reduce hepatic glycogen synthesis and storage capacity, limiting the liver's ability to release glucose during hypoglycemia.
Reduced glycogen storage impairs counterregulatory glucose release, leading to prolonged and severe hypoglycemia after meals or during fasting.
Evidence from Studies
Supporting (1)
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