Introduction and Objective: Gastric bypass surgery (GB) is a treatment for obesity but alters prandial glycemia, increasing the risk of hypoglycemia. Glucagon administration is a potential therapy for post-GB hypoglycemia, but its effects on prandial glycemia or symptoms remain unclear. We investigated the effect of intravenous (IV) glucagon on prandial symptoms in subjects with and without a history of GB.Methods: Eight GB subjects and seven BMI- and age-matched non-operated controls (CN) underwent a mixed meal test, with and without IV glucagon infusion (2 ng/kg/min). Symptoms were measured for 3 hours on a 1-7 scale and categorized into five groups: gastrointestinal (GI; nausea, fullness, rumbling, belching, vomiting, diarrhea), sympathetic nervous system (SNS; shaky, palpitation, anxiety), parasympathetic nervous system (PNS; sweating, hunger, tingling), central nervous system (CNS; tired, warm, confused, weak), and nonspecific (NS; irritability, headache, cold, happy, sad). Symptoms analyzed with Two-way ANOVA with multiple comparisons.Results: Age, BMI, A1C, and baseline symptoms were similar between GB and CN. GI symptoms were significantly higher in GB than CN (p<0.01). GB participants showed higher SNS symptoms (p=0.012), while CN exhibited higher PNS symptoms (p=0.019). CNS and NS symptoms showed no significant differences. Glucagon did not affect glucose levels or GI, SNS, PNS, and NS symptoms. However, glucagon infusion reduced CNS symptoms at nadir glucose levels from 1.88±0.44 to 1.19±0.54 in GB and 1.57±0.40 to 0.29±0.13 in CN (p=0.027).Conclusion: Rerouted gut after GB increased GI and SNS symptoms and reduced PNS symptoms. CNS symptoms associated with nadir glucose are minimized by glucagon infusion without significant changes in glucose. Further research is needed to explore glucagon receptor signals following bariatric surgery, particularly in those suffering from hypoglycemia.
V. Vargas: None. A. Alamdari: None. A.A. Hansis-Diarte: None. A. Gastaldelli: Advisory Panel; Boehringer-Ingelheim. Consultant; Boehringer-Ingelheim, Novo Nordisk, Merck Sharp & Dohme Corp, Regeneron Pharmaceuticals. Other Relationship; Pfizer Inc, Madrigal Pharmaceuticals, Inc, Echosens, Eli Lilly and Company. Speaker’s Bureau; Merck Sharp & Dohme Corp, Eli Lilly and Company, Novo Nordisk. M. Salehi: Advisory Panel; Vognex, Amylyx.
Source link
Leave a Reply