Department of Medicine, Zealand University Hospital, Køge, Denmark.
Clinical Department, Steno Diabetes Center, Copenhagen, Denmark.
Obes Surg. 2020 Apr;30(4):1605-1610. doi: 10.1007/s11695-019-04248-x.
Post-bariatric hypoglycemia (PBH) can be a serious complication after Roux-en-Y gastric bypass (RYGB), and treatment with somatostatin analogs has been suggested. We investigated the acute effects of three different doses of pasireotide (75 μg, 150 μg, and 300 μg) on the postprandial glucose metabolism in five RYGB-operated individuals with PBH using a mixed meal test. All three doses prevented hypoglycemia but were associated with a notable increase in postprandial hyperglycemia. Moreover, all doses greatly diminished insulin, C-peptide, and glucagon-like peptide-1 responses. Considering its strong hyperglycemic potential, we suggest that pasireotide should be administered carefully in RYGB-operated individuals with PBH, and if necessary, a 75 μg dose seems sufficient to prevent hypoglycemia.
减重手术后低血糖（PBH）是 Roux-en-Y 胃旁路术（RYGB）后的一种严重并发症，有人建议使用生长抑素类似物进行治疗。我们使用混合餐试验研究了三种不同剂量的培高利特（75μg、150μg 和 300μg）对 5 例 PBH 的 RYGB 术后个体餐后葡萄糖代谢的急性影响。所有三种剂量都能预防低血糖，但与明显的餐后高血糖有关。此外，所有剂量都大大降低了胰岛素、C 肽和胰高血糖素样肽-1 的反应。考虑到其强烈的升糖作用，我们建议在 RYGB 术后有 PBH 的个体中谨慎使用培高利特，如果需要，75μg 的剂量似乎足以预防低血糖。
