GLP1 analogs as treatment of postprandial hypoglycemia following gastric bypass surgery: a potential new indication?

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Abrahamsson, NiclasUppsala universitet,Klinisk diabetologi och metabolism (author)

GLP1 analogs as treatment of postprandial hypoglycemia following gastric bypass surgery : a potential new indication?

Article/chapterEnglish2013

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2013
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LIBRIS-ID:oai:DiVA.org:uu-213465
https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-213465URI
https://doi.org/10.1530/EJE-13-0504DOI

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Language:English
Summary in:English

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Subject category:art swepub-publicationtype

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Objective: The number of morbidly obese subjects submitted to bariatric surgery is rising worldwide. In a fraction of patients undergoing gastric bypass (GBP), episodes with late postprandial hypoglycemia (PPHG) develop 1-3 years after surgery. The pathogenesis of this phenomenon is not fully understood; meal-induced rapid and exaggerated increases of circulating incretins and insulin appear to be at least partially responsible. Current treatments include low-carbohydrate diets, inhibition of glucose intestinal uptake, reduction of insulin secretion with calcium channel blockers, somatostatin analogs, or diazoxide, a KATP channel opener. Even partial pancreatectomy has been advocated. In type 2 diabetes, GLP1 analogs have a well-documented effect of stabilizing glucose levels without causing hypoglycemia. Design: We explored GLP1 analogs as open treatment in five consecutive GBP cases seeking medical attention because of late postprandial hypoglycemic symptoms. Results: Glucose measured in connection with the episodes in four of the cases had been 2.7, 2.5, 1.8, and 1.6 mmol/l respectively. The patients consistently described that the analogs eliminated their symptoms, which relapsed in four of the five patients when treatment was reduced/discontinued. The drug effect was further documented in one case by repeated 24-h continuous glucose measurements. Conclusion: These open, uncontrolled observations suggest that GLP1 analogs might provide a new treatment option in patients with problems of late PPHG.

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Engström, Britt EdénUppsala universitet,Endokrinologi och mineralmetabolism(Swepub:uu)brittee (author)
Sundbom, MagnusUppsala universitet,Gastrointestinalkirurgi(Swepub:uu)magsundb (author)
Karlsson, Anders F.Uppsala universitet,Klinisk diabetologi och metabolism(Swepub:uu)anderska (author)
Uppsala universitetKlinisk diabetologi och metabolism (creator_code:org_t)

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In:European Journal of Endocrinology169:6, s. 885-8890804-46431479-683X

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