GLP-1 After Gastric Bypass and What You Need to Know w/ Dr. Marilyn Tan

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GLP-1 After Gastric Bypass and What You Need to Know w/ Dr. Marilyn Tan

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Send us Fan MailAfter gastric bypass, some people make so much of their own GLP-1 that their blood sugar rockets after a meal and then crashes, and the juice or glucose tabs meant to rescue them can restart the whole cycle. Stanford endocrinologist Dr. Marilyn Tan explains post-bariatric hypoglycemia, a condition many patients live with for years before anyone names it, and whether GLP-1 medications make sense after surgery for weight regain. Then she shares phase 3 results for avexitide, an investigational drug that works in the opposite direction from the GLP-1 medications everyone is talking about.**IN THIS EPISODE**- Hypoglycemia vs. hyperglycemia in plain language, including what "level 3" low blood sugar means- What your body's own GLP-1 does after you eat, and why gastric bypass and sleeve surgery amplify it- Why diabetes can resolve within days of surgery, before the weight comes off- Whether GLP-1 medications are safe to use after bariatric surgery for weight regain- What post-bariatric hypoglycemia (PBH) is, who tends to get it, and why it often shows up six months or more after surgery- The spike-then-crash pattern one to three hours after a carb-heavy meal- Why the usual low blood sugar advice can backfire for PBH, and what helps stabilize instead- The strict PBH diet (about 30 grams of carbs per meal, 15 per snack) and how it can tip into malnutrition- Why PBH is underdiagnosed, and the new ICD-10 diagnosis code- Inside the phase 3 LUCIDITY trial of avexitide, a GLP-1 blocker that is not FDA approved- What GLP-1 agonists do and don't do for people who already have PBH- What's next for avexitide and who else it may help**ABOUT THE GUEST**Dr. Marilyn Tan, MD, FACE, FACP, is double board certified in Endocrinology and Internal Medicine. She is a Clinical Professor of Medicine at Stanford University School of Medicine and Chief of the Endocrine Clinic at Stanford Health Care. Her clinical focus is outpatient and inpatient diabetes management, and her research includes diabetes and post-bariatric hypoglycemia. She is also actively involved in resident and fellow education and mentorship.**CONNECT WITH DR. MARILYN TAN**Stanford Health Care profile: https://stanfordhealthcare.org/doctors/t/marilyn-tan.html**SPONSOR**This episode is brought to you by Timeline. When you buy a one-month supply of Mitopure Gummies, you'll get a free Discovery Size Mitopure Firming Serum, an $85 value. Go to https://www.timeline.com/glp1bundle to claim yours.**CHAPTERS**00:00 Cold open00:22 Ana's intro01:23 Welcome, Dr. Marilyn Tan02:30 Low vs. high blood sugar, explained04:04 What GLP-1 does when you eat04:27 Why gastric bypass supercharges your GLP-1 response07:02 GLP-1, the brain, and appetite after surgery09:39 Can you take a GLP-1 after bariatric surgery?10:49 Who gets post-bariatric hypoglycemia12:05 The spike and the crash, symptoms to know13:27 Sponsor break, Timeline14:22 Why juice and glucose tabs can backfire14:52 Stabilizing lows and the strict PBH diet17:12 How common PBH is, and its new diagnosis code19:05 Inside the phase 3 avexitide trial20:51 How a GLP-1 blocker works22:04 Do GLP-1 medications help or hurt PBH?24:56 From Ana, the Beyond the Shot guide26:04 The results, 55% fewer serious lows26:51 What happens next for avexitide27:39 Side effects and daily injections29:00 Where to learn more29:50 Beyond bariatric surgery, who else this could help31:08 ClosingMORE FROM GLP-1 HUB📬 Get The Steady State, Ana's weekly newsletter with GLP-1 guidance from a dietitian who's on one: http://join.glp-1hub.com🎙 Subscribe wherever you listen to podcasts, and if this episode helped, leave a quick review on Apple Podcasts or Spotify - it's the single best way to help more people find the show.🌐 Shop GLP-1 essentials, meal plans, and recipes: https://shop.glp-1hub.com📷 Follow on Instagram: @glp1hub📺 Watch on YouTube: https://www.youtube.com/@GLP-1hub*Some of the links shared are affiliate links. When you make a purchase, I will receive a small commission at no cost to you. Thank you for supporting the show.*The content of this show is for informational purposes only and does not constitute medical advice. The goal of this show is to provide various points of view about GLP-1 Medications. The personal and professional opinion of the guests and their content does not necessarily reflect the opinion of Ana Reisdorf or GLP-1 Hub.

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