Exenatide-test for diagnosing endogenous hyperinsulinemic hypoglycaemia: A randomised placebo-controlled cross-over proof-of-principle study – FAST study

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Introduction: The gold standard to diagnose endogenous hyperinsulinemic hypoglycaemia (EHH) is the fasting test which is cumbersome and incurs high costs. In the setting of radio-labelled 68Ga-exendin-4 PET/CT in patients with EHH (to localise insulinoma), we unexpectedly observed clinically relevant hypoglycaemia following administration of the tracer, which does usually not occur after GLP-1 agonist therapy in type 2 diabetic patients and in healthy subjects.

Aim(s): This study aimed at exploring a faster and more comfortable way to diagnose EHH, using i.v. administration of the GLP1-agonist Exenatide.

Materials and methods: Prospective, cross-over, placebo-controlled, proof-of-principle study. 14 patients with confirmed EHH received Exenatide 10μg or placebo iv. randomly assigned on 2 consecutive days. 14 sex-, age-, and BMI-matched controls received 10μg Exenatide open-labelled. Patients were monitored clinically and for blood glucose, insulin, and C-peptide over 4 hours after drug administration.

Conference:

Presenting Author: Christ E

Authors: Hepprich M, Romberg C, Fricke J, Freitag M, Mudry J,

Keywords: endogenous hyperinsulinemic hypoglycaemia, insulinoma, Exendin, Fasting test,