{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T13:53:07Z","timestamp":1753883587006,"version":"3.41.2"},"reference-count":11,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:00:00Z","timestamp":1701388800000},"content-version":"vor","delay-in-days":30,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Postprandial hyperinsulinemic hypoglycemia, although rare, is a well-documented complication that can manifest after upper gastrointestinal surgery. Despite its potential for severe morbidity, the underlying pathogenesis and optimal treatment strategies for this condition remain insufficiently understood. This report presents a compelling case of postprandial hypoglycemia following Billroth-II gastrojejunostomy, characterized by a marked increase in postprandial insulin levels, accompanied by the exaggerated response of incretin hormones. The incretin effect in this patient was found to be exceptionally high, measuring at approximately 90%. While nutritional interventions proved ineffective in alleviating the patient's symptoms, the administration of octreotide significantly attenuated the exaggerated postprandial insulin and incretin response, substantially ameliorating both the symptoms and postprandial hypoglycemia. Monthly subcutaneous injections of long-acting repeatable octreotide were initiated, resulting in the complete resolution of symptomatic postprandial hypoglycemia. Although the patient developed acalculous cholecystitis and gallstone cholangitis 2 years after commencing octreotide therapy, she has remained free from symptomatic postprandial hypoglycemia for more than 4 years. Our case underscores the efficacy of somatostatin analogs in the management of postprandial hyperinsulinemia after gastrointestinal surgery, shedding light on the potential involvement of incretin hormones in the pathophysiology of this condition.<\/jats:p>","DOI":"10.1210\/jcemcr\/luad150","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T11:39:42Z","timestamp":1701430782000},"source":"Crossref","is-referenced-by-count":1,"title":["Successful Treatment of Postprandial Hyperinsulinemic Hypoglycemia After Billroth-II Gastrojejunostomy Using Octreotide"],"prefix":"10.1210","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7031-2446","authenticated-orcid":false,"given":"Masashi","family":"Hasebe","sequence":"first","affiliation":[{"name":"Department of Diabetes and Endocrinology, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai , Kita-ku, Osaka 530-8480 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1529-1141","authenticated-orcid":false,"given":"Megumi","family":"Aizawa-Abe","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai , Kita-ku, Osaka 530-8480 , Japan"},{"name":"Division of Diabetes and Endocrinology, Osaka Saiseikai-Noe Hospital , Osaka 536-0001 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimitaka","family":"Shibue","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai , Kita-ku, Osaka 530-8480 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1903-9752","authenticated-orcid":false,"given":"Akihiro","family":"Hamasaki","sequence":"additional","affiliation":[{"name":"Department of Diabetes and Endocrinology, Medical Research Institute Kitano Hospital, PIIF Tazuke-Kofukai , Kita-ku, Osaka 530-8480 , Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2023,12,1]]},"reference":[{"issue":"8","key":"2023121603032145400_luad150-B1","doi-asserted-by":"crossref","first-page":"2815","DOI":"10.1210\/jc.2018-00528","article-title":"Hypoglycemia after gastric bypass surgery: current concepts and controversies","volume":"103","author":"Salehi","year":"2018","journal-title":"J Clin Endocrinol Metab"},{"issue":"1-2","key":"2023121603032145400_luad150-B2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/j.2040-1124.2010.00010.x","article-title":"Little enhancement of meal-induced glucagon-like peptide 1 secretion in Japanese: comparison of type 2 diabetes patients and healthy controls","volume":"1","author":"Yabe","year":"2010","journal-title":"J Diabetes Investig"},{"issue":"5","key":"2023121603032145400_luad150-B3","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1210\/jcem-54-5-909","article-title":"The role of endogenous gastric inhibitory polypeptide in the enteroinsular axis","volume":"54","author":"Takemura","year":"1982","journal-title":"J Clin Endocrinol Metab"},{"issue":"2","key":"2023121603032145400_luad150-B4","doi-asserted-by":"crossref","first-page":"380","DOI":"10.2337\/diabetes.52.2.380","article-title":"The influence of GLP-1 on glucose-stimulated insulin secretion: effects on beta-cell sensitivity in type 2 and nondiabetic subjects","volume":"52","author":"Kjems","year":"2003","journal-title":"Diabetes"},{"issue":"3","key":"2023121603032145400_luad150-B5","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1056\/NEJMoa043690","article-title":"Hyperinsulinemic hypoglycemia with nesidioblastosis after gastric-bypass surgery","volume":"353","author":"Service","year":"2005","journal-title":"N Engl J Med"},{"issue":"5","key":"2023121603032145400_luad150-B6","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1530\/EJE-11-1065","article-title":"Prolonged successful therapy for hyperinsulinaemic hypoglycaemia after gastric bypass: the pathophysiological role of GLP1 and its response to a somatostatin analogue","volume":"166","author":"Myint","year":"2012","journal-title":"Eur J Endocrinol"},{"issue":"2","key":"2023121603032145400_luad150-B7","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1210\/jc.2006-1578","article-title":"Characterization of somatostatin receptor subtype-specific regulation of insulin and glucagon secretion: an in vitro study on isolated human pancreatic islets","volume":"92","author":"Singh","year":"2007","journal-title":"J Clin Endocrinol Metab"},{"issue":"11","key":"2023121603032145400_luad150-B8","doi-asserted-by":"crossref","first-page":"3094","DOI":"10.1007\/s00125-012-2663-5","article-title":"Somatostatin receptor 5 and cannabinoid receptor 1 activation inhibit secretion of glucose-dependent insulinotropic polypeptide from intestinal K cells in rodents","volume":"55","author":"Moss","year":"2012","journal-title":"Diabetologia"},{"issue":"2","key":"2023121603032145400_luad150-B9","doi-asserted-by":"crossref","first-page":"E311","DOI":"10.1152\/ajpendo.00434.2001","article-title":"Somatostatin-28 regulates GLP-1 secretion via somatostatin receptor subtype 5 in rat intestinal cultures","volume":"283","author":"Chisholm","year":"2002","journal-title":"Am J Physiol Endocrinol Metab"},{"issue":"3","key":"2023121603032145400_luad150-B10","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1053\/j.gastro.2013.11.044","article-title":"Blockade of glucagon-like peptide 1 receptor corrects postprandial hypoglycemia after gastric bypass","volume":"146","author":"Salehi","year":"2014","journal-title":"Gastroenterology"},{"issue":"8","key":"2023121603032145400_luad150-B11","doi-asserted-by":"crossref","first-page":"e3235","DOI":"10.1210\/clinem\/dgab103","article-title":"PREVENT: A randomized, placebo-controlled crossover trial of avexitide for treatment of postbariatric hypoglycemia","volume":"106","author":"Craig","year":"2021","journal-title":"J Clin Endocrinol Metab"}],"container-title":["JCEM Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/1\/6\/luad150\/54078569\/luad150.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcemcr\/article-pdf\/1\/6\/luad150\/54078569\/luad150.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,16]],"date-time":"2023-12-16T03:03:42Z","timestamp":1702695822000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcemcr\/article\/doi\/10.1210\/jcemcr\/luad150\/7456752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11]]},"references-count":11,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,11,3]]}},"URL":"https:\/\/doi.org\/10.1210\/jcemcr\/luad150","relation":{},"ISSN":["2755-1520"],"issn-type":[{"type":"electronic","value":"2755-1520"}],"subject":[],"published-other":{"date-parts":[[2023,11]]},"published":{"date-parts":[[2023,11]]},"article-number":"luad150"}}