Efficacy of Semaglutide in Reactive Hypoglycemia Related to Dumping Syndrome after Bariatric Surgery

Title:Efficacy of Semaglutide in Reactive Hypoglycemia Related to Dumping Syndrome after Bariatric Surgery

Volume: 24

Author(s): Angelo Fiore*, Santoro Gaetano, Lombardo Ausilia, Spitali Federica, Sceusa Giulia and Gullo Damiano

Affiliation:

• ARNAS Garibaldi Nesima, Università degli Studi di Catania, Italy

Abstract:

Introduction: Postprandial hypoglycemia induced by Dumping Syndrome (DS) represents a side effect of bariatric surgery linked to glucose-dependent hyperinsulinemia, which can cause serious symptoms 2-3 hours after the meal hypoglycemia. This clinical case shows the effectiveness of semaglutide, a long-acting GLP1 receptor agonist, in one patient previously subjected to gastric bypass (GBP), with persistent late postprandial hypoglycaemic symptoms occurring after surgery.

Case Report: A female patient, 31 years old, subjected to GBP 10 years earlier, with the diagnosis of diabetes, was admitted to our unit for persistent post-prandial reactive hypoglycemia, confirmed by Flash Glucose Monitoring (FGM) FreeStyle. The patient was intolerant to metformin, had been treated with acarbose with poor results. HbA1c 7.9%. Acarbose was suspended, and semaglutide was started sc at increasing doses, 0.25 mg/week for 1 month and subsequently 0.5 mg/week. After the first few weeks, symptoms of DS were significantly reduced with improvement of the daily glycemic profile and disappearance of hypoglycemic events. The time-below range, time spent with blood glucose <70 mg/dl, decreased by 12% to 4% during treatment with semaglutide 0.25 mg/week, up to 1% with a dose of 0.5 mg/week. The effect of the drug on reducing hypoglycemic episodes was persistent for up to 8 months.

Conclusion: Treatment of post-bariatric reactive hypoglycemia includes nutritional therapy, the use of glucosidase inhibitors, and somatostatin analogues. The use of short-acting GLP-1RA analogues has also recently been reported. In our patient, therapy with semaglutide s.c. significantly reduced episodes of reactive hypoglycemia with an improvement in the quality of life.

Cite this article as:

Fiore Angelo*, Gaetano Santoro, Ausilia Lombardo, Federica Spitali, Giulia Sceusa and Damiano Gullo, Efficacy of Semaglutide in Reactive Hypoglycemia Related to Dumping Syndrome after Bariatric Surgery, Endocrine, Metabolic & Immune Disorders - Drug Targets 2024; 24 () . https://dx.doi.org/10.2174/0118715303318399240715065513