Tharakan G, et al. - Researchers performed a cohort study which indicated that an early peak in glucagon-like-1 peptide (GLP-1) and glucagon, due to post-operative L-cell hypertrophy and aberrant processing of proglucagon, may trigger an exaggerated insulinotropic response to eating in patients with postprandial hypoglycemia (PPH).

Methods

• Researchers examined a cohort of PPH patients at the Imperial Weight Center.
• They conducted continuous glucose monitoring to define their altered glycemic variability.
• They further carried out a mixed meal test (MMT) and measured gut hormone concentrations.

Results

• They observed increased glycemic variability in the cohort of PPH patients, specifically a higher Mean Amplitude Glucose Excursion (MAGE) score of 4.9.
• They also illustrated significantly greater and earlier increases in insulin and GLP-1 concentration in patients who had hypoglycemia in response to an MMT (MMT Hypo) relative to those that did not (MMT Non-Hypo).
• A significantly increased glucagon secretion was observed in the MMT Hypo group versus the Non-hypo group.
• There were no significant differences in oxyntomodulin, GIP or peptide YY secretion between these two groups.