Endocrine Abstracts

Introduction: Reactive hypoglycaemia (RH) is a complex problem, with no definite treatment apart from lifestyle changes.

Methods: We used Sitagliptin in two patients with RH, who had tried lifestyle changes for at least 2 years but without much effect. A gentleman with initial BMI of 31.4 kg/m² and another lady of BMI 24.1 kg/m² was treated with Sitagliptin 100 and 50 mg daily, in view of their weight and thereby volume of distribution, with informed consent about this unlicensed indication.

Results: Within a month, the incidence of hypoglycaemia had gone down to none and in 6 months’ time, the gentleman had lost 11.1 kg, while the lady’s weight remained stable. OGTT performed before and 6 months after treatment with Sitagliptin taken in the morning of the test showed reduction in glycaemic excursions and delay in the onset of hypoglycaemia in both these patients.

Conclusion: DPP-IV inhibitors by their property of glucose mediated insulin release and slowing of gastrointestinal motion, can be useful adjuncts to patients with RH. Further studies on larger number of patients need to be done.