{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T05:50:46Z","timestamp":1776059446894,"version":"3.50.1"},"reference-count":46,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T00:00:00Z","timestamp":1773187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100015223","name":"Danish Diabetes and Endocrine Academy","doi-asserted-by":"publisher","award":["PhD013\u201020"],"award-info":[{"award-number":["PhD013\u201020"]}],"id":[{"id":"10.13039\/100015223","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF17SA0031406"],"award-info":[{"award-number":["NNF17SA0031406"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF23SA0087869"],"award-info":[{"award-number":["NNF23SA0087869"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009708","name":"Novo Nordisk Fonden","doi-asserted-by":"publisher","award":["NNF23SA0084103"],"award-info":[{"award-number":["NNF23SA0084103"]}],"id":[{"id":"10.13039\/501100009708","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Treatment options for post\u2010bariatric hypoglycaemia (PBH) are empirical. We aimed to investigate the efficacy and safety of acarbose and canagliflozin for the treatment of PBH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We performed a randomised, double\u2010blinded, cross\u2010over, placebo\u2010controlled clinical trial where placebo, acarbose 50\u2009mg thrice daily, and canagliflozin 300\u2009mg twice daily were administered for 4\u2009weeks. Treatment effects on blood glucose were monitored through blinded continuous glucose monitoring (CGM) for 10\u2009days at the end of each intervention along with collection of patient\u2010reported outcomes. The primary outcome was the percentage of time below range during CGM (interstitial glucose below 3.9\u2009mM\/70\u2009mg\/dL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eleven participants with Roux\u2010en\u2010Y gastric bypass and documented PBH completed the trial. When compared with placebo, neither canagliflozin nor acarbose reduced the percentage of time below range (primary outcome, time below 3.9\u2009mmol\/L, median (IQR): screening 2.6 (0.7\u20135.1)%, placebo 1.2 (0.5\u20132.4)%, acarbose 1.1 (0.8\u20131.7)% and canagliflozin 0.8 (0.5\u20133.4)%). Both interventions, however, showed exploratory improvements in pre\u2010specified secondary outcomes, including time in range and glycaemic variability, as well as a reduction of symptoms of hypoglycaemia and frequency of symptomatic hypoglycaemic events, particularly with canagliflozin. Acarbose was associated with moderate and common side effects that caused treatment discontinuation in one participant. For both treatments, no severe adverse events were documented.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>HypoBar I is the first randomised, placebo\u2010controlled study of the treatment of PBH with acarbose or canagliflozin. Reduction in time below range was not achieved by either treatment; nevertheless, improvements in hypothesis\u2010generating secondary findings merit further investigation and validation. EudraCT number 2022\u2010000157\u201087.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.70611","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T10:15:41Z","timestamp":1773224141000},"page":"4205-4215","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Acarbose or Canagliflozin vs. Placebo to Ameliorate Post\u2010Bariatric Hypoglycaemia: The Clinical Outcomes of the\n                    <scp>HypoBar<\/scp>\n                    I Randomised Clinical Trial"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3708-6859","authenticated-orcid":false,"given":"Carolina B.","family":"Lobato","sequence":"first","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre Denmark"},{"name":"Department of Biomedical Sciences Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}]},{"given":"Clara Torn\u00f8e","family":"Winding","sequence":"additional","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre Denmark"},{"name":"Department of Biomedical Sciences Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}]},{"given":"Kirstine N.","family":"Bojsen\u2010M\u00f8ller","sequence":"additional","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre Denmark"},{"name":"Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}]},{"given":"Bolette","family":"Hartmann","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences, University of Copenhagen, Novo Nordisk Foundation Centre for Basic Metabolic Research  Copenhagen Denmark"}]},{"given":"Christoffer","family":"Martinussen","sequence":"additional","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre Denmark"}]},{"given":"Simon","family":"Veedfald","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6853-3805","authenticated-orcid":false,"given":"Jens J.","family":"Holst","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"},{"name":"Faculty of Health and Medical Sciences, University of Copenhagen, Novo Nordisk Foundation Centre for Basic Metabolic Research  Copenhagen Denmark"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5017-1815","authenticated-orcid":false,"given":"Sten","family":"Madsbad","sequence":"additional","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre Denmark"},{"name":"Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}]},{"given":"Nils Bruun","family":"J\u00f8rgensen","sequence":"additional","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre Denmark"},{"name":"Department of Clinical Medicine Faculty of Health and Medical Sciences, University of Copenhagen  Copenhagen Denmark"}]},{"given":"Carsten","family":"Dirksen","sequence":"additional","affiliation":[{"name":"Department of Medicine Copenhagen University Hospital \u2013 Amager and Hvidovre, Section of Endocrinology  Hvidovre 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