GLP1R-imaging in Post-RYGB Hypoglycemia

• Signed informed consent

Patients:

• Persisting hyperinsulinemic hypoglycemia after a low-carbohydrate diet and/or insulin suppressive medication for one year.

Controls:

• RYGB at least 2 years ago
• Normal glucose levels before and after RYGB (fasting glucose between 4 and 6 mmol/l or HbA1c between 20 and 42 mmol/mol)
• Score ≤ 7 on Sigstad's scoring system (Table 1)
• Hypoglycemia excluded by 14-day continuous glucose monitoring
• Individual matched to HH group on age (± 5 years), sex and BMI at time of inclusion (± 2 kg/m2)

Exclusion Criteria:

• Anti-diabetic medication in the past 6 months
• Treatment with synthetic Exendin (Exenatide, Byetta®) or Dipeptidyl-Peptidase IV inhibitors in the past six months.
• Known liver failure or serum liver values over 2 times normal value at the time of standard laboratory assessment. Normal values of total bilirubin, γ-GT, ASAT and albumin are \<21 μmol, \<40 U/l, \<30 U/l and 35-50 g/l respectively
• Pregnancy or the wish to become pregnant within 6 months
• Breast feeding
• Kidney failure, i.e. calculated creatinine clearance below 40 ml/min
• Age \< 18 years
• No signed informed consent