Acarbose or Canagliflozin vs. Placebo to Ameliorate Post‐Bariatric Hypoglycaemia: The Clinical Outcomes of the HypoBar I Randomised Clinical Trial
Authors' conclusion
HypoBar I is the first randomised, placebo-controlled study of the treatment of PBH with acarbose or canagliflozin. Reduction in time below range was not achieved by either treatment; nevertheless, improvements in hypothesis-generating secondary findings merit further investigation and validation.
Study context
- Population
- Participants with RYGB and documented post-bariatric hypoglycaemia (PBH)11 completed
- Comparison
- Acarbose or canagliflozin vs placebo
- Primary endpoint
- Percentage of time below range during blinded continuous glucose monitoring (CGM) (interstitial glucose below 3.9 mM/70 mg/dL)
- Follow-up
- 10 days at the end of each intervention
Methodological detailsdouble-blinded, cross-over, placebo-controlled
- Double-blinded
- Cross-over
- Placebo-controlled
Primary result
As reported in the abstract
Time below 3.9 mmol/L
Secondary outcomes
Pre-specified secondary outcomes (exploratory)
- Both interventions showed exploratory improvements in TIR and glycaemic variability, and reduced hypoglycaemia symptoms and frequency of symptomatic hypoglycaemic events, particularly with canagliflozin
Safety
- Acarbose: moderate and common side effects; treatment discontinuation
- 1 participant
- Severe adverse events, both treatments
- 0
Original publication
Acarbose or Canagliflozin vs. Placebo to Ameliorate Post‐Bariatric Hypoglycaemia: The Clinical Outcomes of the HypoBar I Randomised Clinical Trial. Diabetes Obes Metab. Published 11 March 2026. doi:10.
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