October 13, 2005
Nesidioblastosis
Question from San Antonio, Texas, USA:
I was just today diagnosed with nesidioblastosis. I was told this condition is related to gastric bypass surgery I had in 2002. For the last two years, I’ve experienced passing out, sweats, shaking, confusion, etc. The spells would occur about once a week. I was finally diagnosed as being hypoglycemic and was told that this is easily treated with diet, six small meals a day. I have tried this for eight weeks and now I crash at least once a day, sometimes as many as three times a day. I usually feel a crash coming on when my sugar gets to about 38 mg/dl [2.1 mmol/L], but this isn’t always the case. I’ve even had the paramedics called on me twice.
Today, on my own, I saw a digestive specialist thinking this could be related to gastric bypass surgery. He mentioned nesidioblastosis and said it is imperative I see an endocrinologist. Am I on the right track to getting the help I need? My family doctor doesn’t know what to do. He just says my symptoms are “odd”. I know I can’t keep crashing without doing permanent and serious liver, brain and other damage. Please help! There isn’t much out there yet about the correlation between gastric bypass and nesidioblastosis.
Answer:
Yes, this is a relatively new description of a clinical entity that is evident after gastric bypass surgery. I think you are on the right track by seeking consultation with an endocrinologist. I can see how the recurrent lows have been such a blow to your overall wellbeing. The goal of any treatment is directed at preventing the lows. Nesidioblastosis refers to a secondary stimulation of growth in the insulin-producing cells. You will need to discuss this in more depth with your endocrinologist, as well as learning strategies to avoid the lows.
JTL
