ArticleThe Journal of clinical endocrinology and metabolism2009
Increased glucagon-like peptide-1 secretion and postprandial hypoglycemia in children after Nissen fundoplication.
Article in The Journal of clinical endocrinology and metabolism, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed, 61 citations in OpenAlex.
- Trial
- Paradoxical glycemia in an adult withJCEM case reports · 2026Article
- Further Delineation of Clinical Phenotype ofGenes · 2024Article
- Dumping Syndrome in Children: A Narrative Review.Cureus · 2023Review
- Incidence, predictors and outcomes of redo pancreatectomy in infants with congenital hyperinsulinism: a 16-year tertiary center experience.Pediatric surgery international · 2023Review
- The Role of GLP-1 Signaling in Hypoglycemia due to Hyperinsulinism.Frontiers in endocrinology · 2022Review
- Role of Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists in Hypoglycemia.Clinical medicine insights. Endocrinology and diabetes · 2021Review
- Hyperinsulinemic hypoglycemia in children and adolescents: Recent advances in understanding of pathophysiology and management.Reviews in endocrine & metabolic disorders · 2020Review
- Dysregulated insulin in pancreatic insufficient cystic fibrosis with post-prandial hypoglycemia.Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society · 2020Article
- Hypoglycemia After Upper Gastrointestinal Surgery: Clinical Approach to Assessment, Diagnosis, and Treatment.Diabetes, metabolic syndrome and obesity : targets and therapy · 2020Review
- Hypoglycemia After Gastric Bypass Surgery: Current Concepts and Controversies.The Journal of clinical endocrinology and metabolism · 2018Review
- Postprandial Hypoglycemia in Children after Gastric Surgery: Clinical Characterization and Pathophysiology.Hormone research in paediatrics · 2016Article
- Hyperinsulinemic Hypoglycemia - The Molecular Mechanisms.Frontiers in endocrinology · 2016Review
- The Diagnosis and Management of Hyperinsulinaemic Hypoglycaemia.Journal of clinical research in pediatric endocrinology · 2015Review
- The molecular mechanisms, diagnosis and management of congenital hyperinsulinism.Indian journal of endocrinology and metabolism · 2013Article
- Dominant form of congenital hyperinsulinism maps to HK1 region on 10q.Hormone research in paediatrics · 2013Article
- Hyperinsulinaemic hypoglycaemia:genetic mechanisms, diagnosis and management.Journal of clinical research in pediatric endocrinology · 2012Review
- Evaluation of gastric fundus invagination for weight loss in a porcine model.Obesity surgery · 2012Article
- Hyperinsulinaemic hypoglycaemia: genetic mechanisms, diagnosis and management.Journal of inherited metabolic disease · 2012Review
- Postoperative surveillance and detection of postprandial hypoglycemia after fundoplasty in children.The Journal of pediatrics · 2011Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
contextPostprandial hypoglycemia (PPH) is a frequent complication of Nissen fundoplication in children. The mechanism responsible for the PPH is poorly understood, but involves an exaggerated insulin response to a meal and subsequent hypoglycemia. We hypothesize that increased glucagon-like peptide-1 (GLP-1) secretion contributes to the exaggerated insulin surge and plays a role in the pathophysiology of this disorder.
objectiveThe aim of the study was to characterize glucose, insulin, and GLP-1 response to an oral glucose load in children with symptoms of PPH after Nissen fundoplication.
designTen patients with suspected PPH and a history of Nissen fundoplication and eight control subjects underwent a standard oral glucose tolerance test at The Children's Hospital of Philadelphia. Blood glucose (BG), insulin, and intact GLP-1 levels were obtained at various time points.
participantsChildren ages 4 months to 13 years old were studied.
main outcome measuresChange scores for glucose, insulin, and intact GLP-1 were recorded after an oral glucose tolerance test.
resultsAll cases had hypoglycemia after the glucose load. Mean BG at nadir (+/- sd) was 46.7 +/- 11 mg/dl for cases (vs. 85.9 +/- 21.3 mg/dl; P < 0.0005). Mean change in BG from baseline to peak (+/- sd) was 179.3 +/- 87.4 mg/dl for cases (vs. 57.8 +/- 39.5 mg/dl; P = 0.003). Mean change in BG (+/- sd) from peak to nadir was 214.4 +/- 85.9 mg/dl for cases (vs. 55.9 +/- 41.1 mg/dl, P < 0.0005). Mean change in insulin (+/- sd) from baseline to peak was 224.3 +/- 313.7 microIU/ml for cases (vs. 35.5 +/- 22.2 microIU/ml; P = 0.012). Mean change in GLP-1 (+/- sd) from baseline to peak was 31.2 +/- 24 pm (vs. 6.2 +/- 9.5 pm; P = 0.014).
conclusionsChildren with PPH after Nissen fundoplication have abnormally exaggerated secretion of GLP-1, which may contribute to the exaggerated insulin surge and resultant hypoglycemia.
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