Post-bariatric hypoglycaemia — SCE Endocrinology MCQ

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HardDiabetesPost-bariatric hypoglycaemiaSCE Endocrinology

A 40-year-old woman presents with recurrent post-prandial sweating and confusion after Roux-en-Y gastric bypass. Glucose during symptoms is 2.6 mmol/L with suppressed insulin when fasting. What is the most likely diagnosis?

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Correct answer: E — Post-bariatric hypoglycaemia

Post-bariatric hypoglycaemia typically occurs after meals following upper gastrointestinal surgery, whereas insulinoma more often causes fasting hypoglycaemia with inappropriate insulin. Addison's and phaeochromocytoma do not match the meal-related low glucose pattern. Dietary modification is usually the first management step.

Reference: Society for Endocrinology Hypoglycaemia Guidance