7501 The Effect Of Liraglutide On Postprandial Hypoglycemia In Non-Bariatric Surgery Patients; A Case Series And Review Of Literature

Abstract Disclosure: W.M. Almistehi: None. J.A. Alatawi: None. W.A. AlJalal: None. Background: Postprandial hypoglycemia is not an uncommon symptom with various causes and pathophysiology, including exaggerated insulin response related to rapid glucose absorption like in patients with dumping syndrome post-bariatric, Impaired glucagon sensitivity, Insulin resistant-related hyperinsulinemia, Alcohol, and idiopathic. It affects the patient's quality of life, causing autonomic and neuroglycopenic symptoms. In extreme cases, it might be fatal as well. To our knowledge, there are no published studies on using Liraglutide in patients with postprandial hypoglycemia without a history of bariatric surgery. Methods: This case series involved six patients who share a similar presentation to the endocrine clinic in the Obesity, Endocrine and Metabolism Center in King Fahad Medical City-Riyadh, Saudi Arabia. All patients with adrenergic symptoms and hypoglycemia documented less than 65 mg/dl, mainly post-meal, within 3-4 hours. We prescribed Liraglutide and other medical treatment regimens to improve their symptoms and follow them up for up to two years. Results: There are six patients, five females and one male, aged between 22 and 55 years old. They presented with adrenergic symptoms such as sweating, dizziness, hunger, shivering and blurring of vision with documented hypoglycemia less than 65 mg/dl that improved with meal. Of the six patients, four had symptoms triggered by eating, one reported symptoms mainly after stress, and the last had no specific trigger factor. Two patients were started on Acarbose and Diazoxide at doses of 50 mg twice daily and 100 mg Three times daily, respectively, with persistent adrenergic symptoms; those two patients started on Liraglutide 0.6 mg with titration up for a dose of 3 mg daily. Both had significant improvement in symptoms with decreased frequency and severity of hypoglycemia during the two-year follow-up. Another two patients had persistent symptoms while treated only with Acarbose 50 mg thrice daily. The first patient started on Liraglutide 0.6 mg daily and titrated to a dose of 1.8 mg daily for two years with no improvement of symptoms, but the patient was not compliant with the medication. The other patient reached 3 mg daily with partial improvement of symptoms at two years of follow-up. The last two patients started immediately on Liraglutide. The first one takes 1.8 mg daily and has significantly improved his symptoms since starting the medication until eight months follow up (up to date). The last case received 3 mg daily and showed improvement of his hypoglycemia up to two years follow up. Conclusion: Liraglutide might be a good option for treating postprandial hypoglycemic patients with good clinical outcomes. However, more publications are needed to evaluate the efficacy and long-term follow-up in treating this group of patients. Presentation: 6/3/2024