HealthDay News — Subcutaneous exendin (SC Ex-9) appears to be safe and effective in treating post-bariatric hypoglycemia (PBH), according to a study published in Diabetes, Obesity and Metabolism.

Colleen M. Craig, MD, from the Stanford University School of Medicine in California, and colleagues conducted the first in-human subcutaneous administration of Ex-9 in 9 female patients with PBH following Roux-en-Y gastric bypass. First, a single participant underwent equimolar low-dose IV vs subcutaneous Ex-9 administration. Then, 8 participants were administered single ascending doses of SC Ex-9 during oral glucose tolerance testing.

The researchers observed an exposure-response relationship, but all doses effectively prevented hyperinsulinemic hypoglycemia and improved associated symptoms. The postprandial glucose nadir was increased by 66%, peak insulin was reduced by 57%, and neuroglycopenic symptoms were reduced by 80%, on average. No treatment-related adverse events were reported.

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“SC Ex-9 appears to represent a safe, effective, and targeted therapeutic approach for treatment of PBH,” the authors write. “Further investigation involving multiple doses with chronic dosing is warranted.”

Several authors disclosed financial ties to the pharmaceutical industry.

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Craig CM, Liu LF, Nguyen T, et al. Efficacy and pharmacokinetics of subcutaneous exendin (9-39) in patients with post bariatric hypoglycaemia [published online August 4, 2017]. Diabetes Obes Metab.  doi: 10.1111/dom.13078.