Subcutaneous exendin treats post-bariatric hypoglycemia


(HealthDay)—Subcutaneous exendin (SC Ex-9) appears to be safe and effective in treating post-bariatric hypoglycemia (PBH), according to a study published online Aug. 4 in Diabetes, Obesity and Metabolism.

Colleen M. Craig, M.D., from the Stanford University School of Medicine in California, and colleagues conducted the first in-human subcutaneous administration of Ex-9 in nine female patients with PBH following Roux-en-Y gastric bypass. First, a single participant underwent equimolar low-dose IV versus subcutaneous Ex-9 administration. Then, eight participants were administered single ascending doses of SC Ex-9 during oral glucose tolerance testing.

The researchers observed an exposure-response relationship, but all doses effectively prevented hyperinsulinemic hypoglycemia and improved associated symptoms. The postprandial glucose nadir was increased by 66 percent, peak insulin was reduced by 57 percent, and neuroglycopenic symptoms were reduced by 80 percent, on average. No treatment-related adverse events were reported.

“SC Ex-9 appears to represent a safe, effective, and targeted therapeutic approach for treatment of PBH,” the authors write. “Further investigation involving multiple doses with chronic dosing is warranted.”

Several authors disclosed financial ties to the pharmaceutical industry.


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