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Background: Post-bariatric hypoglycemia (PBH) is characterized by repeated episodes of severe hypoglycemia accompanied by neuroglycopenic signs and/or symptoms. Many individuals with PBH report chronic symptoms of cognitive impairment even when blood glucose values are not acutely low. In this study, cognitive function in individuals with PBH compared to age-and BMI-matched healthy controls (HC) was assessed using a quantitative visual paired comparison (VPC) task; a measurement validated to predict cognitive decline and Alzheimer’s disease.

Methods: 20 patients with confirmed PBH (plasma glucose< 50 mg/dL with concomitant insulin≥ 3 uU/mL, other causes having been ruled out) following Roux-en-Y gastric bypass surgery were compared to 54 age-(46±vs. 50±9 yrs, p= 0.05) and BMI-(31±vs. 28±4 kg/m2, p= 0.07) matched HCs. Patient-reported frequency of clinically-important …