SFEEU2024 Society for Endocrinology Clinical Update 2024 Workshop H: Miscellaneous endocrine and metabolic disorders (19 abstracts)
Managing post-bariatric surgery reactive hypoglycaemia: a dual approach with metformin and GLP-1 receptor agonist
Komal Zia Rao 1 , Kavitha Lakshmipathy 1 , Younes R. Younes 1 , Benjamin C.T. Field 1,2 , Vidhu Nayyar 1 , James Clark 1 , Sunil Zachariah 1 & Julian Emmanuel 1
1East Surrey Hospital, Surrey & Sussex Healthcare NHS Trust, Redhill, United Kingdom.; 2Section of Clinical Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, United Kingdom
A 61-year old woman, referred to the endocrine clinic, post Roux-en-Y gastric bypass, exhibited symptoms of dizziness, weakness, light-headedness and sweating. These symptoms were associated with light meal following prolonged fast. A clinical diagnosis of reactive hypoglycaemia was made. She was advised to make lifestyle modification and adopted a low glycaemic index diet. Baseline bloods including cortisol, IGF-1 and urinary metanephrine were within reference range. Mixed meal test revealed rapid fluctuations in blood glucose; exaggerated insulin(545 pmol/l) and C peptide (2316 pmol/l) response, at blood glucose of 11.6 mmol/l. This glucose fluctuation seemed to precipitate symptoms. CT pancreas revealed no evidence of pancreatic lesion. Metformin was initiated in March 2018, titrated to the maximum dose. She was in remission from diabetes after bariatric surgery. Her BMI was 42.4 kg/m2. Her frequency of symptoms improved with metformin, but she occasionally experienced hypoglycaemia in the morning, thus a trial of weekly GLP-1 receptor agonist was commenced resulting in resolution of symptoms. This case suggests potential efficacy of dual therapy with metformin and GLP1 receptor agonist in managing reactive hypoglycaemia post- bariatric surgery.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more