SUN-619 Outpatient Treatment of Post-Bariatric Hypoglycemia with Canagliflozin
Abstract
Abstract Disclosure: E. Looi: None. H.M. Lawler: None. Objective: Post-bariatric hypoglycemia (PBH) is a complication that develops after bariatric surgery and treatment options are limited. After Roux-en-Y gastric bypass (RYGB), there is increased expression of intestinal sodium-glucose cotransporters (SGLT-1), which may worsen postprandial hyperglycemia and stimulate exaggerated insulin secretion. At doses ≥ 200mg, canagliflozin, an SGLT-2 inhibitor, also inhibits SGLT-1. The goal of this study was to examine canagliflozin’s efficacy in treating PBH in a real-world setting. We hypothesized canagliflozin, an SGLT-1/2 inhibitor, would lead to reduced postprandial hyperglycemia and hypoglycemia. Methods: Retrospective analysis was performed on continuous glucose monitor (CGM) data of four patients, 3 female and 1 male, with PBH after RYGB (mean PBH onset 2.3 years, mean pre-op BMI 45.3 kg/m2) who took canagliflozin 300 mg daily for at least one month (mean duration of use 2.3 months). Post-prandial was defined as a rise in blood glucose (BG) > 20 mg/dL from baseline BG and the post-prandial period was defined as the 4-hour period after the start of the BG rise. The number of CGM postprandial hyperglycemic episodes (> 180-250 mg/dL and > 250mg/dL) and CGM postprandial level 1 (54-69mg/dL) and level 2 ( 180 mg/dL (p = 0.48), hyperglycemic events with BG > 250 mg/dL (p = 0.41), level 1 hypoglycemic events (p = 0.27), or level 2 hypoglycemic events (p = 0.14). Subjectively, one…
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