SUN-703 Post Bariatric Hypoglycemia Successfully Treated With GLP-1 Receptor Agonist
Abstract
Abstract Disclosure: S. Khan: None. A. Lampe Dominguez: None. Background: Post-bariatric hypoglycemia (PBH) is a serious complication of bariatric surgery that is challenging to treat. While the precise mechanism remains unclear, PBH is thought to result, in part, from accelerated nutrient transit to the small intestine, leading to an exaggerated release of insulin and incretins, such as GLP-1. Interestingly, although GLP-1 is implicated in the pathogenesis of PBH, a few case reports have documented improvement of PBH with GLP-1 receptor agonists. Here we present the case of a patient with PBH successfully treated using a GLP-1 receptor agonist. Case: A 54-year-old female with a history of Roux-en-Y gastric bypass six years prior presented to the clinic following a hypoglycemic seizure. She had been following a ketogenic diet but had been nonadherent in the week leading up to the event. Two hours after consuming a high carbohydrate meal, she experienced a seizure with a recorded blood sugar of <20 mg/dL. Home glucose log revealed multiple episodes of postprandial hypoglycemia (50-60 mg/dL) within two hours of eating, without fasting hypoglycemia. Labs included: AM cortisol 11.9 ug/dL, Insulin 7.0 uIU/mL, C-peptide 2.0 ng/mL, TSH 4.180. Alternative causes of hypoglycemia, including medication-induced, insulinoma, and adrenal insufficiency, were ruled out. PBH was diagnosed based on her postprandial hypoglycemia pattern. After unsuccessful trials or contraindications to…
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