ArticleDiabetes technology & therapeutics2018
Design and Clinical Evaluation of a Novel Low-Glucose Prediction Algorithm with Mini-Dose Stable Glucagon Delivery in Post-Bariatric Hypoglycemia.
Article in Diabetes technology & therapeutics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- A Randomized, Placebo-Controlled Double-Blind Trial of a Closed-Loop Glucagon System for Postbariatric Hypoglycemia.The Journal of clinical endocrinology and metabolism · 2020Trial
- Post-bariatric hypoglycaemia: from altered gut physiology to targeted therapies.Endocrine connections · 2026Article
- A personalized and automated real-time meal detection algorithm based on continuous glucose monitoring and heart rate data for individuals with post-bariatric hypoglycemia.Frontiers in digital health · 2026Article
- Modeling Meal Absorption in Subjects Post-Roux-en-Y Gastric Bypass Surgery Leading to Post-Bariatric Hypoglycemia.Control Technology and Applications. Control Technology and Applications · 2025Article
- Automatic identification of unreported meals from continuous glucose monitoring data in individuals after bariatric surgery using a template matching algorithm.Scientific reports · 2025Article
- Tailoring Exercise Prescription for Effective Diabetes Glucose Management.The Journal of clinical endocrinology and metabolism · 2025Review
- Towards a decision support system for post bariatric hypoglycaemia: development of forecasting algorithms in unrestricted daily-life conditions.BMC medical informatics and decision making · 2025Article
- Hypoglycemia post bariatric surgery: drugs with different mechanisms of action to treat a unique disorder.Archives of endocrinology and metabolism · 2023Review
- Forecasting postbariatric hypoglycaemia in patients after Roux-en-Y gastric bypass using model-based algorithms fed by continuous glucose monitoring data: A proof-of-concept study.Diabetes, obesity & metabolism · 2022Article
- Review
- Digital Solutions to Diagnose and Manage Postbariatric Hypoglycemia.Frontiers in nutrition · 2022Review
- Glycemic Patterns Are Distinct in Post-Bariatric Hypoglycemia After Gastric Bypass (PBH-RYGB).The Journal of clinical endocrinology and metabolism · 2021Article
- Hyperinsulinemic hypoglycemia in children and adolescents: Recent advances in understanding of pathophysiology and management.Reviews in endocrine & metabolic disorders · 2020Review
- Hypoglycemia After Upper Gastrointestinal Surgery: Clinical Approach to Assessment, Diagnosis, and Treatment.Diabetes, metabolic syndrome and obesity : targets and therapy · 2020Review
- Management of Diabetes in Patients Undergoing Bariatric Surgery.Current diabetes reports · 2019Review
- Novel Preparations of Glucagon for the Prevention and Treatment of Hypoglycemia.Current diabetes reports · 2019Review
- Postprandial hypoglycemia after gastric bypass surgery: from pathogenesis to diagnosis and treatment.Current opinion in clinical nutrition and metabolic care · 2019Review
- Hypoglycemia After Gastric Bypass Surgery: Current Concepts and Controversies.The Journal of clinical endocrinology and metabolism · 2018Review
Corrections and comments
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Authors and funding
14 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPostbariatric hypoglycemia (PBH) is a complication of bariatric surgery with limited therapeutic options. We developed an event-based system to predict and detect hypoglycemia based on continuous glucose monitor (CGM) data and recommend delivery of minidose liquid glucagon.
methodsWe performed an iterative development clinical study employing a novel glucagon delivery system: a Dexcom CGM connected to a Windows tablet running a hypoglycemia prediction algorithm and an Omnipod pump filled with an investigational stable liquid glucagon formulation. Meal tolerance testing was performed in seven participants with PBH and history of neuroglycopenia. Glucagon was administered when hypoglycemia was predicted. Primary outcome measures included the safety and feasibility of this system to predict and prevent severe hypoglycemia. Secondary outcomes included hypoglycemia prediction by the prediction algorithm, minimization of time below hypoglycemia threshold using glucagon, and prevention of rebound hyperglycemia.
resultsThe hypoglycemia prediction algorithm alerted for impending hypoglycemia in the postmeal state, prompting delivery of glucagon (150 μg). After observations of initial incomplete efficacy to prevent hypoglycemia in the first two participants, system modifications were implemented: addition of PBH-specific detection algorithm, increased glucagon dose (300 μg), and a second glucagon dose if needed. These modifications, together with rescue carbohydrates provided to some participants, contributed to progressive improvements in glucose time above the hypoglycemia threshold (75 mg/dL).
conclusionsPreliminary results indicate that our event-based automatic monitoring algorithm successfully predicted likely hypoglycemia. Minidose glucagon therapy was well tolerated, without prolonged or severe hypoglycemia, and without rebound hyperglycemia.
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Registered trials
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