Efficacy of Liraglutide in reactive hypoglycemia related to Dumping syndrome

HulyaAbbasova

Abstract

  Efficacy of Liraglutide in reactive hypoglycemia related to Dumping syndrome   HulyaAbbasova Therapist in the endocrinology department of the Educational-Therapeutic Clinic of Azerbaijan Medical University   Abstract Reactive hypoglycemia (postprandial hypoglycemia) refers to low blood sugar that occurs after a meal — usually within four hours after eating. Dumping syndrome is one of the reasons that lead to reactive hypoglycemia. It is a condition that can develop after gastric surgery. Dumping syndrome occurs when food, especially sugar, moves from the stomach into the small bowel too quickly. Late dumping syndrome starts one to three hours after a high-sugar meal. The signs and symptoms develop that long after eating because the body releases large amounts of insulin to absorb the sugars entering the small intestine. The result is low blood sugar. Liraglutide is a glucagon-like peptid-1 analog that has been shown to slow gastric emptying. This case report shows its efficacy in dumping syndrome related postprandial hypoglycemia. Our patient was an 18-year-old male who underwent vagotomy for gastroesophageal acid reflux. He presented for 3 months with palpitations, sweating, and weakness 2 hours after meals. Whipple's Triad was confirmed. Both 72 hours fasting and mixed-meal (5 hours) tests were negative. Gastric Emptying Scintigraphy was performed and as a result gastric emptying was accelerated up to 38 minutes (N=45-90 minutes). Based on the history of the present illness, past medical history, normal findings of blood chemistry test, late dumping syndrome was considered the cause of postprandial hypoglycemia. Dietary recommendations were given; Acarbose 50 mg tid was prescribed. But symptoms still were present. We added Liraglutide injections to the prescription with starting dose 0.6 mg and further titrating. The patient’s condition was significantly improved.   Biography: Dr. HulyaAbbasova has been graduated from Azerbaijan Medical University as a Medical Doctor. Later on she finished residency with the specialty Therapist in the endocrinology department of the Educational-Therapeutic Clinic of Azerbaijan Medical University. She completed her speciality education in Endocrinology and Metabolic Diseases at Istanbul and Ege Universities. Presently she has been working at the private hospital. She worked on this case during herstudy course at theEge University in Izmir. Bottom Note: This abstract has been taken from the International Webinar on Endocrinology&  Diabetology held as an online webinar on July 27, 2020