Sitaglitpin phosphate treatment in patients with reactive hypoglycemia secondary to dysinsulinism....

We evaluated the effect of sitagliptin in correction of symptomatic reactive hypoglycemia.

Randomized, double blind, placebo-controlled clinical trial. Thirteen patients treated with sitagliptin and 15 with placebo, with mean age of 34.3 ± 10.6 years and body mass index of 24.6 ± 5.1 kg/m², mostly women (n = 24, 85.7%), were evaluated.

Basal glycemia was similar in placebo versus sitagliptin (92.3 ± 18.9 vs. 93.4 ± 17.3 mg/dl; p = 0.41) as was median and interquartile range of insulin (15.2 [8.8-43.7] vs. 14.7 µU/ml [7.0-39.0]; p = 0.44). Patients with sitagliptin recovered the first phase insulin secretion (FISP). This was related with higher glucose level at the end of the oral glucose tolerance test (79.5 [74.2-83.0] vs. 83.5 [81.2-89.7]; p = 0.003) with a similar insulin median level (13.0 [5.0-34.4] vs. 13.8 [4.8-30.6]; p = 0.32). Symptomatology was significantly lower under sitagliptin treatment (p < 0.0001).

Sitagliptin improved FISP and reduced post-prandial symptomatology. These results suggest a novel therapeutic option for patients with reactive hypoglycemia related with FISP.