Evaluation of Dietary, Pharmacologic, and Endoscopic Interventions for Post-Bariatric Hypoglycemia

Summary

Post-bariatric hypoglycemia (PBH) is a complication of upper gastrointestinal surgery that causes recurrent episodes of low blood sugar after eating and can substantially impair quality of life. Currently, there are no approved therapies specifically indicated for PBH. The purpose of this study is to better understand the physiological mechanisms underlying PBH and to evaluate three therapeutic approaches that may reduce hypoglycemia: dietary modification, treatment with a GLP-1 receptor agonist or dual GIP/GLP-1 receptor agonist, and transoral outlet reduction (TORe). Participants will undergo detailed metabolic testing, including continuous glucose monitoring, mixed meal tolerance testing, and gastric emptying scintigraphy, to determine how these interventions affect gastric emptying, glucose regulation, insulin secretion, gut hormone responses, and hypoglycemia.

Eligibility

Age range

18–70 years

Sex

All

Healthy volunteers

No

Interventions

• Behavioral
  Dietary Intervention

  Standardized dietary interventions evaluating the effects of meal composition (carbohydrate alone, carbohydrate plus fat, and carbohydrate plus protein) on postprandial hypoglycemia.

• Drug
  GLP-1 receptor agonist or Dual GIP/GLP-1 receptor agonist

  Treatment with a GLP-1 receptor agonist (semaglutide) or dual GIP/GLP-1 receptor agonist (tirzepatide) administered for approximately 12 weeks to evaluate its effects on postprandial hypoglycemia.

• Other
  Transoral Outlet Reduction (TORe)

  Endoscopic transoral outlet reduction (TORe) performed as part of routine clinical care. Research participants undergo study assessments before and after the clinically indicated procedure.

Location