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Using type 2 treatments after weight loss surgery

Project summary

Dr Dimitris Papamargaritis wants to find out if a common type 2 diabetes treatment – called canagliflozin – could be used to protect people who have had weight loss surgery against low blood sugar levels. This study will provide more information about how canagliflozin works, and may identify a treatment to improve post-surgery quality of life.

Background to research

Weight loss surgery is offered to some people who are obese, many of whom are at high risk of developing type 2 diabetes. But after surgery, patients can experience low blood sugar levels – or a ‘hypo’. We don’t yet fully understand why this happens, or how to stop it.

Canagliflozin is used to treat type 2 diabetes, as it increases the amount of sugar filtered out of the blood and into the urine instead, helping to manage blood sugar levels. Scientists have shown that canagliflozin also has an effect in people without diabetes: it appears to tell the pancreas to produce less insulin, leading to higher blood sugar levels.

Dr Papamargaritis wants to see if he can take advantage of this phenomenon and find a treatment to prevent post-surgery hypos.

Research aims

Dr Papamargaritis wants to investigate the effect of canagliflozin on blood sugar levels in people without diabetes after weight-loss surgery. To do this, he will give 12 study participants canagliflozin for five days. Participants will then drink a milkshake, and Dr Papamargaritis will measure their blood sugar levels, insulin production and gut hormone levels to see how they respond. This will be repeated three weeks later, after the canagliflozin has left their system.

Another 12 participants will do the same study, but in reverse: no treatment for five days, a three-week break, then canagliflozin for five days. Dr Papamargaritis will then compare the results from the two groups.

Participants will also wear glucose monitoring devices whilst in the study, to understand how canagliflozin affects blood sugar levels in everyday life.

Potential benefit to people with diabetes

Weight loss surgery can help some people who are obese to reduce their risk of type 2 diabetes, and this research could help to improve their quality of life post-surgery. It will also help us to understand more about how a common treatment for type 2 diabetes works, to inform the development of new treatments in the future.

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