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Pramlintide for post-bariatric hypoglycaemia.

Amanda Sheehan1, Allison Goldfine1,2, Muhammed Bajwa1

  • 1Research Division, Joslin Diabetes Center, Boston, Massachusetts, USA.

Diabetes, Obesity & Metabolism
|February 9, 2022
PubMed
Summary
This summary is machine-generated.

Pramlintide did not reduce hypoglycemia in patients with post-bariatric hypoglycemia (PBH). The study found no significant changes in glucose levels, insulin response, or satiety after 8 weeks of treatment.

Keywords:
bariatric surgerycontinuous glucose monitoring (CGM)glucagonhypoglycaemia

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Area of Science:

  • Endocrinology
  • Metabolic Disorders
  • Pharmacology

Background:

  • Post-bariatric hypoglycemia (PBH) is a condition characterized by rapid glucose drops after meals.
  • Current management strategies for PBH are limited, necessitating exploration of novel therapeutic agents.

Purpose of the Study:

  • To evaluate the efficacy of pramlintide in reducing the frequency and severity of hypoglycemia in patients with PBH.
  • To investigate pramlintide's effects on gastric emptying, postprandial glucagon, and insulin secretion in PBH.

Main Methods:

  • An 8-week open-label study involving 14 participants with PBH who received escalating doses of subcutaneous pramlintide.
  • Mixed-meal tolerance tests (MMTT) and continuous glucose monitoring (CGM) were used to assess glycemic excursions, hormonal responses, and hypoglycemia events.

Main Results:

  • Pramlintide treatment did not significantly alter MMTT glucose, glucagon, or insulin levels compared to baseline.
  • No significant changes were observed in satiety or dumping scores.
  • The overall frequency of low sensor glucose (SG) values remained unchanged, despite inter-individual variability.

Conclusions:

  • Pramlintide is ineffective in modulating glycemic or insulin responses, satiety, or dumping scores in PBH patients.
  • Pramlintide does not impact glycemic excursions or reduce low SG levels in the outpatient management of PBH.