Effect of alcohol ingestion on plasma glucose kinetics after Roux-en-Y gastric bypass surgery

María Belén Acevedo, Ramiro Ferrando, Bruce W. Patterson, J. Christopher Eagon, Samuel Klein, Marta Yanina Pepino

Research output: Contribution to journalArticle

Abstract

Background: Roux-en-Y gastric bypass surgery (RYGB) increases the rate of alcohol absorption so that peak blood alcohol concentration is 2-fold higher after surgery compared with concentrations reached after consuming the same amount presurgery. Because high doses of alcohol can lead to hypoglycemia, patients may be at increased risk of developing hypoglycemia after alcohol ingestion. Objectives: We conducted 2 studies to test the hypothesis that the consumption of approximately 2 standard drinks of alcohol would decrease glycemia more after RYGB than before surgery. Setting: Single-center prospective randomized trial. Methods: We evaluated plasma glucose concentrations and glucose kinetics (assessed by infusing a stable isotopically labelled glucose tracer) after ingestion of a nonalcoholic drink (placebo) or an alcoholic drink in the following groups: (1) 5 women before RYGB (body mass index = 43 ± 5 kg/m 2 ) and 10 ± 2 months after RYGB (body mass index = 31 ± 7 kg/m 2 ; study 1), and (2) 8 women who had undergone RYGB surgery 2.2 ± 1.2 years earlier (body mass index = 30 ± 5 kg/m 2 ; study 2) Results: Compared with the placebo drink, alcohol ingestion decreased plasma glucose both before and after surgery, but the reduction was greater before (glucose nadir placebo = −.4 ± 1.0 mg/dL versus alcohol = −9.6 ± 1.5 mg/dL) than after (glucose nadir placebo = −1.0 ± 1.6 mg/dL versus alcohol = −5.5 ± 2.6 mg/dL; P <.001) surgery. This difference was primarily due to an alcohol-induced early increase followed by a subsequent decrease in the rate of glucose appearance into systemic circulation. Conclusion: RYGB does not increase the risk of hypoglycemia after consumption of a moderate dose of alcohol.

Original languageEnglish (US)
Pages (from-to)36-42
Number of pages7
JournalSurgery for Obesity and Related Diseases
Volume15
Issue number1
DOIs
StatePublished - Jan 2019

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Gastric Bypass
Eating
Alcohols
Glucose
Placebos
Hypoglycemia
Body Mass Index

Keywords

  • Alcohol
  • Bariatric surgery
  • Ethanol
  • Glucose
  • Glucose kinetics
  • Glycemia
  • Hypoglycemia
  • Metabolic surgery

ASJC Scopus subject areas

  • Surgery

Cite this

Effect of alcohol ingestion on plasma glucose kinetics after Roux-en-Y gastric bypass surgery. / Acevedo, María Belén; Ferrando, Ramiro; Patterson, Bruce W.; Eagon, J. Christopher; Klein, Samuel; Pepino, Marta Yanina.

In: Surgery for Obesity and Related Diseases, Vol. 15, No. 1, 01.2019, p. 36-42.

Research output: Contribution to journalArticle

Acevedo, María Belén ; Ferrando, Ramiro ; Patterson, Bruce W. ; Eagon, J. Christopher ; Klein, Samuel ; Pepino, Marta Yanina. / Effect of alcohol ingestion on plasma glucose kinetics after Roux-en-Y gastric bypass surgery. In: Surgery for Obesity and Related Diseases. 2019 ; Vol. 15, No. 1. pp. 36-42.
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title = "Effect of alcohol ingestion on plasma glucose kinetics after Roux-en-Y gastric bypass surgery",
abstract = "Background: Roux-en-Y gastric bypass surgery (RYGB) increases the rate of alcohol absorption so that peak blood alcohol concentration is 2-fold higher after surgery compared with concentrations reached after consuming the same amount presurgery. Because high doses of alcohol can lead to hypoglycemia, patients may be at increased risk of developing hypoglycemia after alcohol ingestion. Objectives: We conducted 2 studies to test the hypothesis that the consumption of approximately 2 standard drinks of alcohol would decrease glycemia more after RYGB than before surgery. Setting: Single-center prospective randomized trial. Methods: We evaluated plasma glucose concentrations and glucose kinetics (assessed by infusing a stable isotopically labelled glucose tracer) after ingestion of a nonalcoholic drink (placebo) or an alcoholic drink in the following groups: (1) 5 women before RYGB (body mass index = 43 ± 5 kg/m 2 ) and 10 ± 2 months after RYGB (body mass index = 31 ± 7 kg/m 2 ; study 1), and (2) 8 women who had undergone RYGB surgery 2.2 ± 1.2 years earlier (body mass index = 30 ± 5 kg/m 2 ; study 2) Results: Compared with the placebo drink, alcohol ingestion decreased plasma glucose both before and after surgery, but the reduction was greater before (glucose nadir placebo = −.4 ± 1.0 mg/dL versus alcohol = −9.6 ± 1.5 mg/dL) than after (glucose nadir placebo = −1.0 ± 1.6 mg/dL versus alcohol = −5.5 ± 2.6 mg/dL; P <.001) surgery. This difference was primarily due to an alcohol-induced early increase followed by a subsequent decrease in the rate of glucose appearance into systemic circulation. Conclusion: RYGB does not increase the risk of hypoglycemia after consumption of a moderate dose of alcohol.",
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T1 - Effect of alcohol ingestion on plasma glucose kinetics after Roux-en-Y gastric bypass surgery

AU - Acevedo, María Belén

AU - Ferrando, Ramiro

AU - Patterson, Bruce W.

AU - Eagon, J. Christopher

AU - Klein, Samuel

AU - Pepino, Marta Yanina

PY - 2019/1

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N2 - Background: Roux-en-Y gastric bypass surgery (RYGB) increases the rate of alcohol absorption so that peak blood alcohol concentration is 2-fold higher after surgery compared with concentrations reached after consuming the same amount presurgery. Because high doses of alcohol can lead to hypoglycemia, patients may be at increased risk of developing hypoglycemia after alcohol ingestion. Objectives: We conducted 2 studies to test the hypothesis that the consumption of approximately 2 standard drinks of alcohol would decrease glycemia more after RYGB than before surgery. Setting: Single-center prospective randomized trial. Methods: We evaluated plasma glucose concentrations and glucose kinetics (assessed by infusing a stable isotopically labelled glucose tracer) after ingestion of a nonalcoholic drink (placebo) or an alcoholic drink in the following groups: (1) 5 women before RYGB (body mass index = 43 ± 5 kg/m 2 ) and 10 ± 2 months after RYGB (body mass index = 31 ± 7 kg/m 2 ; study 1), and (2) 8 women who had undergone RYGB surgery 2.2 ± 1.2 years earlier (body mass index = 30 ± 5 kg/m 2 ; study 2) Results: Compared with the placebo drink, alcohol ingestion decreased plasma glucose both before and after surgery, but the reduction was greater before (glucose nadir placebo = −.4 ± 1.0 mg/dL versus alcohol = −9.6 ± 1.5 mg/dL) than after (glucose nadir placebo = −1.0 ± 1.6 mg/dL versus alcohol = −5.5 ± 2.6 mg/dL; P <.001) surgery. This difference was primarily due to an alcohol-induced early increase followed by a subsequent decrease in the rate of glucose appearance into systemic circulation. Conclusion: RYGB does not increase the risk of hypoglycemia after consumption of a moderate dose of alcohol.

AB - Background: Roux-en-Y gastric bypass surgery (RYGB) increases the rate of alcohol absorption so that peak blood alcohol concentration is 2-fold higher after surgery compared with concentrations reached after consuming the same amount presurgery. Because high doses of alcohol can lead to hypoglycemia, patients may be at increased risk of developing hypoglycemia after alcohol ingestion. Objectives: We conducted 2 studies to test the hypothesis that the consumption of approximately 2 standard drinks of alcohol would decrease glycemia more after RYGB than before surgery. Setting: Single-center prospective randomized trial. Methods: We evaluated plasma glucose concentrations and glucose kinetics (assessed by infusing a stable isotopically labelled glucose tracer) after ingestion of a nonalcoholic drink (placebo) or an alcoholic drink in the following groups: (1) 5 women before RYGB (body mass index = 43 ± 5 kg/m 2 ) and 10 ± 2 months after RYGB (body mass index = 31 ± 7 kg/m 2 ; study 1), and (2) 8 women who had undergone RYGB surgery 2.2 ± 1.2 years earlier (body mass index = 30 ± 5 kg/m 2 ; study 2) Results: Compared with the placebo drink, alcohol ingestion decreased plasma glucose both before and after surgery, but the reduction was greater before (glucose nadir placebo = −.4 ± 1.0 mg/dL versus alcohol = −9.6 ± 1.5 mg/dL) than after (glucose nadir placebo = −1.0 ± 1.6 mg/dL versus alcohol = −5.5 ± 2.6 mg/dL; P <.001) surgery. This difference was primarily due to an alcohol-induced early increase followed by a subsequent decrease in the rate of glucose appearance into systemic circulation. Conclusion: RYGB does not increase the risk of hypoglycemia after consumption of a moderate dose of alcohol.

KW - Alcohol

KW - Bariatric surgery

KW - Ethanol

KW - Glucose

KW - Glucose kinetics

KW - Glycemia

KW - Hypoglycemia

KW - Metabolic surgery

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