Nutritional strategies for correcting low glucose values in patients with postbariatric hypoglycaemia: A randomized controlled three‐arm crossover trial
Authors' conclusion
Correcting hypoglycaemia with 15 g of glucose should be reconsidered in post-RYGB PBH. A lower dose appears to sufficiently increase glucose levels outside the critical range in most cases, and complementary nutrients (e.g. proteins) may provide glycaemia-stabilizing benefits.
Study context
- Population
- Post-RYGB adults with postbariatric hypoglycaemia (mean [SD] 7.0 [1.4] years since surgery); hypoglycaemia induced by solid mixed meal, corrected at plasma glucose <3.0 mmol/Lcrossover
- Participants
- 8 adults
- Comparison
- Hypoglycaemia correction with 15 g glucose vs 5 g glucose vs protein bar
- Primary endpoint
- Percentage of time in target plasma glucose range (3.9-5.5 mmol/L)
- Follow-up
- 40 minutes after correction
Methodological detailsthree-arm crossover
- Three-arm crossover
Primary result
As reported in the abstract
Time in target glucose range (3.9-5.5 mmol/L) · 40 minutes postcorrection
- Did not differ significantly between the interventions
- Between G15 and G5: P = 0.161
Further findings
| Outcome | P value |
|---|---|
| Postcorrection time with glucose <3.9 mmol/LG15 vs P10 · lower after G15 | P = 0.007 |
| Glucagon 15 min postcorrection · 15 minutes postcorrectionP10 vs G15 · higher after P10 | P = 0.002 |
| Glucagon 15 min postcorrection · 15 minutes postcorrectionP10 vs G5 · higher after P10 | P = 0.003 |
Time with glucose >5.5 mmol/L, peak glucose and insulin 15 min postcorrection
- Higher after G15 than G5 and P10
- P < 0.001
Safety
- Rebound hypoglycaemia (< 3.0 mmol/L) — G15
- 38%
- Rebound hypoglycaemia (< 3.0 mmol/L): three of eight cases with G15
Rebound hypoglycaemia (< 3.0 mmol/L)
- No rebound hypoglycaemia occurred with G5 and P10
Original publication
Nutritional strategies for correcting low glucose values in patients with postbariatric hypoglycaemia: A randomized controlled three‐arm crossover trial. Diabetes Obes Metab. Published 19 June 2023. doi:10.
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