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The efficacy of GLP‐1RAs for the management of postprandial hypoglycemia following bariatric surgery : a systematic review
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Llewellyn, David C., Logan Ellis, Hugh, Aylwin, Simon J. B., Oštarijaš, Eduard, Green, Shauna, Sheridan, William, Chew, Nicholas W. S., le Roux, Carel W., Miras, Alexander D., Patel, Ameet G., Vincent, Royce P. and Dimitriadis, Georgios K. (2023) The efficacy of GLP‐1RAs for the management of postprandial hypoglycemia following bariatric surgery : a systematic review. Obesity, 31 (1). pp. 20-30. doi:10.1002/oby.23600 ISSN 1930-7381.
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WRAP-efficacy-GLP‐1RAs-management-postprandial-hypoglycemia-following-bariatric-surgery-Dimitriadis-2023.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (2689Kb) | Preview |
Official URL: http://dx.doi.org/10.1002/oby.23600
Abstract
Objective:
Postprandial hyperinsulinemic hypoglycemia with neuroglycopenia is an increasingly recognized complication of Roux-en-Y gastric bypass and gastric sleeve surgery that may detrimentally affect patient quality of life. One likely causal factor is glucagon-like peptide-1 (GLP-1), which has an exaggerated rise following ingestion of carbohydrates after bariatric surgery. This paper sought to assess the role of GLP-1 receptor agonists (GLP-1RAs) in managing postprandial hypoglycemia following bariatric surgery.
Methods:
MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov, and Scopus were systematically and critically appraised for all peer-reviewed publications that suitably fulfilled the inclusion criteria established a priori. This systematic review was developed according to the Preferred Reporting Items for Systematic Review and Meta-Analyses Protocols (PRISMA-P). It followed methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions and is registered with PROSPERO (International Prospective Register of Systematic Reviews; identifier CRD420212716429).
Results and Conclusions:
Postprandial hyperinsulinemic hypoglycemia remains a notoriously difficult to manage metabolic complication of bariatric surgery. This first, to the authors' knowledge, systematic review presents evidence suggesting that use of GLP-1RAs does not lead to an increase of hypoglycemic episodes, and, although this approach may appear counterintuitive, the findings suggest that GLP-1RAs could reduce the number of postprandial hypoglycemic episodes and improve glycemic variability.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RD Surgery | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Obesity -- Surgery -- Complications, Surgery -- Complications, Obesity -- Surgery, Endocrinology | ||||||||
Journal or Publication Title: | Obesity | ||||||||
Publisher: | Nature Publishing Group | ||||||||
ISSN: | 1930-7381 | ||||||||
Official Date: | January 2023 | ||||||||
Dates: |
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Volume: | 31 | ||||||||
Number: | 1 | ||||||||
Page Range: | pp. 20-30 | ||||||||
DOI: | 10.1002/oby.23600 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 1 February 2023 | ||||||||
Date of first compliant Open Access: | 2 February 2023 |
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