Glucagon Treatment for Post-Gastric Bypass Hypoglycemia
Glucagon Treatment for Post-Gastric Bypass Hypoglycemia
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DOI：
10.1038/oby.2010.15
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发表时间：
2010-09-01
期刊：
影响因子：
6.9
通讯作者：
Goldfine, Allison B.
中科院分区：
文献类型：
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作者：
Halperin, Florencia;Patti, Mary E.;Goldfine, Allison B.
高胰岛素血症是Roux-en-Y胃旁路手术(RYGB)的一种新近报道的并发症。我们假设，给予胰升糖素将通过刺激肝脏葡萄糖输出来帮助维持正常的餐后血糖浓度，如果是这样的话，这将是一种治疗搭桥术后低血糖的新选择。在这项研究中，我们比较了一名RYGB术后严重复发性低血糖患者服用混合餐加和不加加用胰高血糖素对胰岛素和血糖的反应。尽管注射胰高血糖素能有效地短暂提高餐后血糖，但它也与较高的胰岛素浓度有关，并且不能预防症状性低血糖。此病例表明，胰升糖素在治疗RYGB术后高胰岛素低血糖方面的临床应用可能有限。
Hyperinsulinemic hypoglycemia is a recently described complication of Roux-en-Y gastric bypass (RYGB). We hypothesized that glucagon administration would help maintain normal postprandial plasma glucose concentrations by stimulating hepatic glucose output, and if so, represent a new therapeutic option for postbypass hypoglycemia. In this study, we compared the insulin and glycemic response to a mixed meal with and without concomitant glucagon infusion in a patient with severe recurrent hypoglycemia after RYGB. Although effective in transiently raising postprandial plasma glucose values, glucagon infusion was also associated with higher insulin concentrations, and failed to prevent symptomatic hypoglycemia. This case demonstrates that glucagon may have limited clinical utility in the treatment of post-RYGB hyperinsulinemic hypoglycemia.