| Popis: |
Postprandial hypoglycemia is a disabling complication of the treatment of obesity by bariatric surgery. So far, no therapy exists, and the underlying mechanisms remain unclear. Here, we hypothesized that glucose-induced IL-1β leads to an exaggerated insulin response in this condition. Therefore, we conducted a placebo-controlled, randomized, double-blind, cross-over study with the SGLT2-inhibitor empagliflozin and the IL-1 receptor antagonist anakinra. Both drugs reduced postprandial insulin release and prevented hypoglycemia. Moreover, analysis of monocytes ex vivo revealed a hyper-reactive inflammatory state that resembles an exaggerated response to a meal. Our study proposes a role for glucose-induced IL-1β in postprandial hypoglycemia after bariatric surgery and suggests that SGLT2-inhibitors and IL-1 antagonism may improve this condition. |
