Pub Date : 2024-11-16DOI: 10.1016/j.orcp.2024.11.004
Diego Moriconi, Laura Pucci, Vincenzo Longo, Luca Antonioli, Rosario Bellini, Domenico Tricò, Simona Baldi, Monica Nannipieri
Introduction: post-bariatric hypoglycemia (PBH) is considered a chronic complication after gastric bypass (RYGB) impacting roughly 30 % of patients. Current treatments often focus on nutritional interventions to reduce the frequency of episodes. This prospective study evaluated the effectiveness of Lisosan G (LG), a fermented wheat-based supplement added to the diet, in mitigating PBH episodes and elucidating its mechanism of action on the gut-pancreas axis.
Methods: twenty subjects with PBH, who had undergone RYGB between 2015 and 2018, were enrolled. Subjects underwent clinical examination, blood test, and a 3-hour oral glucose load test (OGTT). Then, they were monitored for 2-weeks on a free diet with continuous glucose monitoring (CGM), which was extended for another 2-weeks after introduction of LG supplementation (5 g, twice daily) on the same diet. Finally, subjects repeated OGTT and blood test. PBH was defined as interstitial glucose ≤ 54 mg/dl.
Results: after treatment, a marked reduction in PBH time was observed (75[23-113] vs 16 [0-33], minutes, p < 0.001). During OGTT, there was an increase in glucose nadir (44 ± 11 vs 56 ± 10, mg/dl, p = 0.038), and a significantly decrease in total GLP-1 AUC (7.6 ± 4.1 vs 6.5 ± 3.8, nmol/L*min, p = 0.043), in potentiation factor ratio (p = 0.037) and in total insulin AUC (57 ± 12 vs 49 ± 9, nmol/L*min, p = 0.043).
Conclusion: LG effectively reduces PBH frequency and duration, probably by attenuating GLP-1 concentrations and leading to a decrease in the second phase of insulin secretion in response to glucose. These findings underscore the promise of LG as a novel adjunct therapy for PBH, particularly when added to the diet, and emphasize the need for further exploration into its microbiota-modulating and anti-inflammatory effects.
{"title":"Efficacy of Lisosan G (fermented wheat) on reactive hypoglycemia after bariatric surgery.","authors":"Diego Moriconi, Laura Pucci, Vincenzo Longo, Luca Antonioli, Rosario Bellini, Domenico Tricò, Simona Baldi, Monica Nannipieri","doi":"10.1016/j.orcp.2024.11.004","DOIUrl":"https://doi.org/10.1016/j.orcp.2024.11.004","url":null,"abstract":"<p><strong>Introduction: </strong>post-bariatric hypoglycemia (PBH) is considered a chronic complication after gastric bypass (RYGB) impacting roughly 30 % of patients. Current treatments often focus on nutritional interventions to reduce the frequency of episodes. This prospective study evaluated the effectiveness of Lisosan G (LG), a fermented wheat-based supplement added to the diet, in mitigating PBH episodes and elucidating its mechanism of action on the gut-pancreas axis.</p><p><strong>Methods: </strong>twenty subjects with PBH, who had undergone RYGB between 2015 and 2018, were enrolled. Subjects underwent clinical examination, blood test, and a 3-hour oral glucose load test (OGTT). Then, they were monitored for 2-weeks on a free diet with continuous glucose monitoring (CGM), which was extended for another 2-weeks after introduction of LG supplementation (5 g, twice daily) on the same diet. Finally, subjects repeated OGTT and blood test. PBH was defined as interstitial glucose ≤ 54 mg/dl.</p><p><strong>Results: </strong>after treatment, a marked reduction in PBH time was observed (75[23-113] vs 16 [0-33], minutes, p < 0.001). During OGTT, there was an increase in glucose nadir (44 ± 11 vs 56 ± 10, mg/dl, p = 0.038), and a significantly decrease in total GLP-1 AUC (7.6 ± 4.1 vs 6.5 ± 3.8, nmol/L*min, p = 0.043), in potentiation factor ratio (p = 0.037) and in total insulin AUC (57 ± 12 vs 49 ± 9, nmol/L*min, p = 0.043).</p><p><strong>Conclusion: </strong>LG effectively reduces PBH frequency and duration, probably by attenuating GLP-1 concentrations and leading to a decrease in the second phase of insulin secretion in response to glucose. These findings underscore the promise of LG as a novel adjunct therapy for PBH, particularly when added to the diet, and emphasize the need for further exploration into its microbiota-modulating and anti-inflammatory effects.</p>","PeriodicalId":19408,"journal":{"name":"Obesity research & clinical practice","volume":null,"pages":null},"PeriodicalIF":2.5,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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