Mizagliflozin for Post-Bariatric Hypoglycemia

(EMERGE Trial)

This trial tests a new drug, mizagliflozin, to determine if it can safely prevent low blood sugar in individuals who have undergone Roux-en-Y bariatric surgery and experience post-bariatric hypoglycemia. The study compares two different doses of mizagliflozin with a placebo (a pill with no active drug) to identify the most effective option. Individuals who had this type of surgery over a year ago and frequently experience low blood sugar episodes might be suitable candidates.

As a Phase 2 trial, this research focuses on evaluating the treatment's effectiveness in an initial, smaller group of participants.

Research has shown that mizagliflozin is generally safe for patients. Studies examining repeated use of the drug found that common side effects were similar to those of a placebo, a harmless pill used for comparison. This indicates that negative reactions did not significantly differ from those experienced by people not taking the drug. Additionally, no major safety issues were reported. Some individuals might experience mild stomach problems, but these were not more severe than those observed in placebo recipients. This suggests mizagliflozin may be safe for many, though individual reactions can vary.¹²³⁴⁵

Most treatments for post-bariatric hypoglycemia focus on dietary changes and medications like acarbose that slow carbohydrate absorption. However, Mizagliflozin is unique because it targets the renal glucose transport system. This new mechanism of action helps reduce blood sugar spikes by promoting glucose excretion through urine. Researchers are excited about Mizagliflozin because it offers a novel way to manage blood sugar levels, potentially providing a more effective and convenient option for patients struggling with this condition.

Research has shown that mizagliflozin may help treat low blood sugar in individuals who have undergone weight loss surgery. In this trial, participants will receive either a placebo or mizagliflozin at doses of 5mg or 10mg. Studies found that mizagliflozin can lower peak blood sugar levels by 21% and reduce severe low blood sugar episodes by 50% to 67%, depending on the dose. Importantly, these benefits occurred without major side effects. This suggests mizagliflozin could be a useful treatment for managing low blood sugar after bariatric surgery.⁶⁷⁸⁹¹⁰