PMID- 31144430
OWN - NLM
STAT- MEDLINE
DCOM- 20200713
LR  - 20200713
IS  - 1463-1326 (Electronic)
IS  - 1462-8902 (Linking)
VI  - 21
IP  - 9
DP  - 2019 Sep
TI  - Postprandial hypoglycaemia after Roux-en-Y gastric bypass and the effects of 
      acarbose, sitagliptin, verapamil, liraglutide and pasireotide.
PG  - 2142-2151
LID - 10.1111/dom.13796 [doi]
AB  - AIM: To investigate the effects of acarbose, sitagliptin, verapamil, liraglutide 
      and pasireotide on post-bariatric hypoglycaemia (PBH) after Roux-en-Y gastric 
      bypass. MATERIALS AND METHODS: In a randomized crossover study, 11 women who had 
      undergone Roux-en-Y gastric bypass and had documented hypoglycaemia were each 
      evaluated during a baseline period without treatment and during five treatment 
      periods with the following interventions: acarbose 50 mg for 1 week, sitagliptin 
      100 mg for 1 week, verapamil 120 mg for 1 week, liraglutide 1.2 mg for 3 weeks 
      and pasireotide 300 mug as a single dose. Treatment effects were evaluated by a 
      mixed-meal tolerance test (MMTT) and, for all treatment periods except 
      pasireotide, by 6 days of continuous glucose monitoring (CGM). RESULTS: Treatment 
      with acarbose and treatment with pasireotide both significantly lifted nadir 
      glucose levels (mean +/- SEM 3.9 +/- 0.2 and 7.9 +/- 0.4 vs 3.4 +/- 0.2; P < .03) and 
      reduced time in hypoglycaemia during the MMTTs. Acarbose reduced peak glucose 
      levels and time in hyperglycaemia, whereas pasireotide greatly increased both 
      variables. Acarbose and pasireotide reduced insulin and C-peptide levels, and 
      pasireotide also diminished glucagon-like peptide-1 levels. Sitagliptin lowered 
      nadir glucose values, while verapamil and liraglutide had no effect on 
      hypoglycaemia. During the CGM periods, the treatments had no impact on 
      hypoglycaemia, whereas acarbose and liraglutide reduced hyperglycaemia and 
      glycaemic variability. CONCLUSIONS: In an experimental setting, treatment with 
      acarbose and pasireotide reduced PBH. Acarbose appears to have an overall 
      glucose-stabilizing effect, whereas pasireotide leads to increased and sustained 
      hyperglycaemia.
CI  - (c) 2019 John Wiley & Sons Ltd.
FAU - Ohrstrom, Caroline Christfort
AU  - Ohrstrom CC
AUID- ORCID: 0000-0003-3148-7504
AD  - Department of Medicine, Zealand University Hospital, Koge, Denmark.
FAU - Worm, Dorte
AU  - Worm D
AD  - Department of Medicine, Amager Hospital, Amager, Denmark.
FAU - Hojager, Anna
AU  - Hojager A
AD  - Department of Medicine, Zealand University Hospital, Koge, Denmark.
FAU - Andersen, Ditte
AU  - Andersen D
AD  - Department of Medicine, Zealand University Hospital, Koge, Denmark.
FAU - Holst, Jens Juul
AU  - Holst JJ
AD  - Department of Biomedical Sciences and Novo Nordisk Foundation Centre for Basic 
      Metabolic Research, University of Copenhagen, Copenhagen, Denmark.
FAU - Kielgast, Urd Lynge
AU  - Kielgast UL
AD  - Department of Medicine, Zealand University Hospital, Koge, Denmark.
FAU - Hansen, Dorte Lindqvist
AU  - Hansen DL
AD  - Clinical Department, Steno Diabetes Center, Copenhagen, Denmark.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20190624
PL  - England
TA  - Diabetes Obes Metab
JT  - Diabetes, obesity & metabolism
JID - 100883645
RN  - 0 (Blood Glucose)
RN  - 0 (Hypoglycemic Agents)
RN  - 51110-01-1 (Somatostatin)
RN  - 839I73S42A (Liraglutide)
RN  - 89750-14-1 (Glucagon-Like Peptide 1)
RN  - 98H1T17066 (pasireotide)
RN  - CJ0O37KU29 (Verapamil)
RN  - T58MSI464G (Acarbose)
RN  - TS63EW8X6F (Sitagliptin Phosphate)
SB  - IM
MH  - Acarbose/therapeutic use
MH  - Adult
MH  - Blood Glucose/drug effects
MH  - Blood Glucose Self-Monitoring
MH  - Cross-Over Studies
MH  - Female
MH  - Gastric Bypass/*adverse effects/methods
MH  - Glucagon-Like Peptide 1/drug effects
MH  - Humans
MH  - Hypoglycemia/blood/*drug therapy
MH  - Hypoglycemic Agents/*therapeutic use
MH  - Liraglutide/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*blood/surgery
MH  - Postoperative Complications/blood/*drug therapy
MH  - Postprandial Period
MH  - Sitagliptin Phosphate/therapeutic use
MH  - Somatostatin/analogs & derivatives/therapeutic use
MH  - Treatment Outcome
MH  - Verapamil/therapeutic use
OTO - NOTNLM
OT  - GLP-1
OT  - bariatric surgery
OT  - clinical trial
OT  - continuous glucose monitoring
OT  - hypoglycaemia
EDAT- 2019/05/31 06:00
MHDA- 2020/07/14 06:00
CRDT- 2019/05/31 06:00
PHST- 2019/03/19 00:00 [received]
PHST- 2019/05/17 00:00 [revised]
PHST- 2019/05/28 00:00 [accepted]
PHST- 2019/05/31 06:00 [pubmed]
PHST- 2020/07/14 06:00 [medline]
PHST- 2019/05/31 06:00 [entrez]
AID - 10.1111/dom.13796 [doi]
PST - ppublish
SO  - Diabetes Obes Metab. 2019 Sep;21(9):2142-2151. doi: 10.1111/dom.13796. Epub 2019 
      Jun 24.