PMID- 24086087
OWN - NLM
STAT- MEDLINE
DCOM- 20131216
LR  - 20220310
IS  - 1479-683X (Electronic)
IS  - 0804-4643 (Linking)
VI  - 169
IP  - 6
DP  - 2013 Dec
TI  - GLP1 analogs as treatment of postprandial hypoglycemia following gastric bypass 
      surgery: a potential new indication?
PG  - 885-9
LID - 10.1530/EJE-13-0504 [doi]
AB  - 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.
FAU - Abrahamsson, Niclas
AU  - Abrahamsson N
AD  - Departments of Medical Sciences, University Hospital.
FAU - Engstrom, Britt Eden
AU  - Engstrom BE
FAU - Sundbom, Magnus
AU  - Sundbom M
FAU - Karlsson, F Anders
AU  - Karlsson FA
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20131021
PL  - England
TA  - Eur J Endocrinol
JT  - European journal of endocrinology
JID - 9423848
RN  - 0 (Blood Glucose)
RN  - 0 (Incretins)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
SB  - IM
MH  - Adult
MH  - Blood Glucose/metabolism
MH  - Diabetes Mellitus, Type 2/*drug therapy/metabolism
MH  - Female
MH  - *Gastric Bypass/adverse effects
MH  - Glucagon-Like Peptide 1/*analogs & derivatives/*therapeutic use
MH  - Humans
MH  - Hypoglycemia/*drug therapy/etiology
MH  - Incretins/blood
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/surgery
MH  - *Postprandial Period
MH  - Treatment Outcome
EDAT- 2013/10/03 06:00
MHDA- 2013/12/18 06:00
CRDT- 2013/10/03 06:00
PHST- 2013/10/03 06:00 [entrez]
PHST- 2013/10/03 06:00 [pubmed]
PHST- 2013/12/18 06:00 [medline]
AID - EJE-13-0504 [pii]
AID - 10.1530/EJE-13-0504 [doi]
PST - epublish
SO  - Eur J Endocrinol. 2013 Oct 21;169(6):885-9. doi: 10.1530/EJE-13-0504. Print 2013 
      Dec.