Status:

RECRUITING

Glucagon Dose-Response in Patients With Post-Bariatric Hypoglycemia

Lead Sponsor:

Joslin Diabetes Center

Collaborating Sponsors:

University of Alabama at Birmingham

University of Virginia

Conditions:

Hypoglycemia

Hypoglycemia, Reactive

Eligibility:

All Genders

18-70 years

Phase:

PHASE4

Brief Summary

The purpose of the study is to determine how blood sugar levels in individuals with and without hypoglycemia after bariatric surgery respond to different doses of glucagon, a hormone that is usually p...

Detailed Description

Visit 1 (Screening) This visit will last about 2 hours. You will be instructed to come to Joslin Diabetes Center after fasting for at least 8 hours (nothing but water for eight hours before your visi...

Eligibility Criteria

Inclusion

  • Inclusion criteria:
  • Age 18-70 years of age, inclusive, at screening.
  • Willingness to provide informed consent and follow all study procedures, including attending all scheduled visits.
  • Males or females diagnosed with ongoing PBH, at least 2 years following Roux-en-Y gastric bypass (RYGB), with documented episodes of hypoglycemia, and history of fulfillment of Whipple's triad.
  • Exclusion criteria:
  • Documented hypoglycemia occurring only in the fasting state (\>12 hours fast);
  • Current diabetes, defined as hemoglobin A1c \>6.5% or use of diabetes medications, except for acarbose or miglitol;
  • Chronic kidney disease stage 4 or 5 (including end-stage renal disease);
  • Hepatic disease, including serum ALT or AST greater than 2 times the upper limit of normal; hepatic synthetic insufficiency as defined as serum albumin \< 3.0 g/dL; or serum bilirubin \> 2.0;
  • Congestive heart failure, NYHA class II, III or IV;
  • History of myocardial infarction, unstable angina or revascularization within the past 6 months.
  • Two or more risk factors for coronary artery disease including diabetes, uncontrolled hypertension, uncontrolled hyperlipidemia, and active tobacco use.
  • History of recurrent syncope (unrelated to hypoglycemia) or active diagnosis of a cardiac arrhythmia;
  • Current administration of β-blocker therapy;
  • History of a cerebrovascular accident;
  • Seizure disorder (other than with suspect or documented hypoglycemia);
  • Active treatment with long-acting (LAR) octreotide or pasireotide;
  • Active malignancy, except basal cell or squamous cell skin cancers;
  • Personal or family history of pheochromocytoma or disorder with increased risk of pheochromocytoma (MEN 2, neurofibromatosis, or Von Hippel-Lindau disease);
  • Known insulinoma;
  • Major surgical operation within 30 days prior to screening;
  • Clinically significant anemia as defined as a hematocrit \< 33%;
  • Bleeding disorder, treatment with warfarin, or platelet count \<50,000;
  • Blood donation (1 pint of whole blood) within the past 2 months;
  • Active alcohol abuse or substance abuse;
  • Current administration of oral or parenteral corticosteroids;
  • Pregnancy and/ or lactation: For women of childbearing potential: there is a requirement for a negative urine pregnancy test before any procedures.
  • Not enrolled in another study that uses an investigational drug for this condition.
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  • Exclusion Criteria:
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Exclusion

    Key Trial Info

    Start Date :

    November 26 2024

    Trial Type :

    INTERVENTIONAL

    Allocation :

    ESTIMATED

    End Date :

    September 1 2026

    Estimated Enrollment :

    28 Patients enrolled

    Trial Details

    Trial ID

    NCT06986603

    Start Date

    November 26 2024

    End Date

    September 1 2026

    Last Update

    May 30 2025

    Active Locations (2)

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    Page 1 of 1 (2 locations)

    1

    University of Alabama

    Birmingham, Alabama, United States, 35233

    2

    Joslin Diabetes Center

    Boston, Massachusetts, United States, 02215