Treatment for Gastric Bypass Patients Suffering from Hypoglycemia

Blocking the action of gut hormone Glucagon-like Peptide 1 (GLP-1) can correct post-meal hypoglycemia in gastric bypass patients, according to a study published in Gastroenterology.

Researchers tested 9 patients with current hypoglycemia after gastric bypass, 7 patients who were asymptomatic after gastric bypass, and 8 healthy control subjects. Participants ate a mixed-meal tolerance test over 2 days: on day 1 they received continuous infusion of the GLP-1 receptor and on the other day they received saline control. Before and after the meals, researchers measured glucose kinetics and islet and gut hormone responses.

Inhibiting GLP-1 corrected the hypoglycemia in the 9 patients with symptoms after gastric bypass. Post-meal blood sugar levels were effectively corrected in all patients and insulin secretion in affected subjects was lowered.

“Over the years we have recognized that gastric bypass is very effective for treatment of obesity and has an immediate and robust effect on glucose improvement in patients with Type 2 diabetes,” said lead investigator Marzieh Salehi, MD. “However, there is a subgroup of patients where gastric bypass surgery creates a situation of hypoglycemia, associated with too much of insulin secretion after meal ingestion, several years after surgery.”