I had gastric bypass surgery two years ago. Before that, I was diabetic. Now, I have reactive hypoglycemia. I saw my doctor today for a check-up and he’s having me tested for nesidioblastosis. I go in for blood work tomorrow. My doctor told me that if I have this condition, I would need to have surgery and have part of my pancreas removed. Is this the only treatment?

This has been a more frequently reported problem in the last few years. With marked obesity, the body compensates by increasing the mass of insulin-producing cells in the pancreas. All of a sudden, after the surgery, the need to use all that extra insulin-producing function is not there anymore. Still, the extra insulin secretion persists because the cells that make up insulin have been stimulated. If insulin production and secretion is so bad as to cause recurrent life-threatening hypoglycemia, then the approach is to remove functioning beta cells to reduce the risk of the extra insulin secretion. There is no chronic medical therapy that has evolved to treat this.

JTL