Canagliflozin: A New Therapeutic Option in Patients That Present Postprandial Hyperinsulinemic Hypoglycemia after Roux-en-Y Gastric Bypass: A Pilot Study
| Autor: | Irene Hernandez, Natividad Lopez, Marina Giralt, Efrain Cordero, Enzamaria Fidilio, Marta Comas, Ramon Vilallonga, Roser Ferrer, Carla Gonzalez, Andreea Ciudin, Rafael Simó, Marta Sánchez, Cristina Hernández |
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| Přispěvatelé: | Institut Català de la Salut, [Ciudin A, Hernández C, Simó R] Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBER de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, Barcelona, Spain. Servei d’Endocrinologia i Nutrició, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Sánchez M] Endocrinology and Nutrition Department, Hospital Universitario Gran Canaria Doctor Negrín, Las Palmas, Spain. [Hernandez I, Cordero E, Comas M, Lopez N] Servei d’Endocrinologia i Nutrició, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Fidilio E] Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. [Gonzalez C] Servei d’Angioradiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Vilallonga R] Unitat de Cirurgia Endocrina, Metabòlica i Bariàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Giralt M] Servei de Bioquímica Clínica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Ferrer R] Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. Servei de Bioquímica Clínica, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Rok vydání: | 2021 |
| Předmět: |
Blood Glucose
obesity medicine.medical_specialty RC620-627 Health (social science) Obesitat - Cirurgia - Complicacions bariatric surgery Gastric Bypass Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] Context (language use) Pilot Projects terapéutica::manejo de la obesidad::bariatría::cirugía bariátrica::derivación gástrica [TÉCNICAS Y EQUIPOS ANALÍTICOS DIAGNÓSTICOS Y TERAPÉUTICOS] Hypoglycemia medicine.disease_cause Other subheadings::Other subheadings::/drug therapy [Other subheadings] Otros calificadores::Otros calificadores::/efectos adversos [Otros calificadores] Gastroenterology enfermedades nutricionales y metabólicas::enfermedades metabólicas::trastornos del metabolismo de la glucosa::hipoglucemia [ENFERMEDADES] postprandial hypoglycemia Hipoglucèmia - Tractament Nutritional and Metabolic Diseases::Metabolic Diseases::Glucose Metabolism Disorders::Hypoglycemia [DISEASES] Physiology (medical) Internal medicine medicine Other subheadings::Other subheadings::/adverse effects [Other subheadings] Humans TX341-641 Prospective Studies Canagliflozin Nutritional diseases. Deficiency diseases Hyperinsulinemic hypoglycemia Nutrition. Foods and food supply business.industry nutritional and metabolic diseases medicine.disease Roux-en-Y anastomosis Obesity Morbid Postprandial Basal (medicine) Therapeutics::Obesity Management::Bariatrics::Bariatric Surgery::Gastric Bypass [ANALYTICAL DIAGNOSTIC AND THERAPEUTIC TECHNIQUES AND EQUIPMENT] business pharmacological therapy medicine.drug Postprandial Hypoglycemia Research Article |
| Zdroj: | Obes Facts Scientia Obesity Facts, Pp 1-7 (2021) |
| ISSN: | 1662-4033 |
| Popis: | Introduction: Roux-en-Y gastric bypass (RYGB) is the most common surgical procedure for morbid obesity. However, it can present serious late complications, like postprandial hyperinsulinemic hypoglycemia (PHH). Recent data suggested an increase in intestinal SGLT-1 after RYGB. However, there is no data on the inhibition of SGLT-1 to prevent PHH in patients with prior RYBG. On this basis, we aimed to evaluate (a) the effect of canagliflozin 300 mg on the response to 100 g glucose overload (oral glucose tolerance test [OGTT]); (b) the pancreatic response after intra-arterial calcium stimulation in the context of PHH after RYGB. Materials and Methods: This is a prospective pilot study including patients (n = 21) with PHH after RYGB, matched by age and gender with healthy controls (n = 5). Basal OGTT and after 2 weeks of daily 300 mg of canagliflozin was performed in all cases. In addition, venous sampling after intra-arterial calcium stimulation of the pancreas was performed in 10 cases. Results: OGTT after canagliflozin showed a significant reduction of plasma glucose levels (minute 30: 161.5 ± 36.22 vs. 215.9 ± 58.11 mg/dL; minute 60: 187.46 ± 65.88 vs. 225.9 ± 85.60 mg/dL, p < 0.01) and insulinemia (minute 30: 95.6 ± 27.31 vs. 216.35 ± 94.86 mg/dL, p = 0.03; minute 60: 120.85 ± 94.86 vs. 342.64 ± 113.32 mIU/L, p < 0.001). At minute 180, a significant reduction (85.7%) of the rate of hypoglycemia was observed after treatment with canagliflozin (p < 0.00001). All cases presented normal pancreatic response after intra-arterial calcium administration. Conclusion: Canagliflozin (300 mg) significantly decreased glucose absorption and prevented PHH after 100 g OGTT in patients with RYGB. Our results suggest that canagliflozin could be a new therapeutic option for patients that present PHH after RYGB. |
| Databáze: | OpenAIRE |
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