Semaglutide for Refractory Reactive Hypoglycaemia: A Case Report.

Kalimuthu H, Seekkuge G, Joseph S

Cureus17 Jul 2026

PMID42605357PMCIDPMC13477730DOI10.7759/cureus.112861PepBankPUB-42605357

Summary

Reactive hypoglycaemia is characterised by symptomatic hypoglycaemia occurring several hours after food intake and can significantly impair quality of life. Management is often challenging, particularly in patients who fail dietary modification or cannot tolerate conventional pharmacological therapies. We present the case of a 50-year-old woman with longstanding, debilitating reactive hypoglycaemia who experienced marked symptomatic and biochemical improvement following treatment with semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist. The patient presented with recurrent episodes of dizziness, profound fatigue, tremulousness, and syncope despite adherence to dietary recommendations. Previous treatment with acarbose was discontinued because of gastrointestinal intolerance, and metformin failed to improve symptoms. Continuous glucose monitoring and an oral glucose tolerance test confirmed reactive hypoglycaemia. Following initiation of semaglutide, the patient experienced a substantial reduction in hypoglycaemic episodes with corresponding improvement in glucose profiles and quality of life. This case highlights the potential role of semaglutide as a novel therapeutic option in patients with refractory reactive hypoglycaemia and contributes to the emerging evidence supporting the use of GLP-1 receptor agonists in this condition.

CC BYText from Europe PMC. Highlighted sentences are the source of results.

Results from this study3

3 results from studies that gave the peptide. 3 results from people.

01HumanCase report or seriesEfficacy outcome
In a 50-year-old woman with refractory reactive hypoglycaemia, hypoglycaemic episodes were substantially reduced after semaglutide was started.
In plain wordsIn one woman with repeated low blood sugar after meals, low blood sugar episodes dropped a lot after she started semaglutide.
Peptide
Semaglutide
Outcome
DecreaseHypoglycaemic episodes
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Following initiation of semaglutide, the patient experienced a substantial reduction in hypoglycaemic episodes
1 context sentence(design, population, supporting numbers)
Summary · context
We present the case of a 50-year-old woman with longstanding, debilitating reactive hypoglycaemia who experienced marked symptomatic and biochemical improvement following treatment with semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
Show in the study text Report a problemFND-4260535701
02HumanCase report or seriesEfficacy outcome
In a 50-year-old woman with refractory reactive hypoglycaemia, glucose profiles improved after semaglutide was started.
In plain wordsIn one woman with repeated low blood sugar after meals, her glucose readings improved after she started semaglutide.
Peptide
Semaglutide
Outcome
Not applicableGlucose profiles
Study
n = 1
Outcome group
Glycemic control · Metabolic and weight
Studied dose
Dose not stated
Source sentences
Summary
Following initiation of semaglutide, the patient experienced a substantial reduction in hypoglycaemic episodes with corresponding improvement in glucose profiles
1 context sentence(design, population, supporting numbers)
Summary · context
We present the case of a 50-year-old woman with longstanding, debilitating reactive hypoglycaemia who experienced marked symptomatic and biochemical improvement following treatment with semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
Show in the study text Report a problemFND-4260535702
03HumanCase report or seriesEfficacy outcome
In a 50-year-old woman with refractory reactive hypoglycaemia, quality of life improved after semaglutide was started.
In plain wordsIn one woman with repeated low blood sugar after meals, her quality of life improved after she started semaglutide.
Peptide
Semaglutide
Outcome
IncreaseQuality of life
Study
n = 1
Outcome group
Quality of life · Whole body
Studied dose
Dose not stated
Source sentences
Summary
Following initiation of semaglutide, the patient experienced a substantial reduction in hypoglycaemic episodes with corresponding improvement in glucose profiles and quality of life
1 context sentence(design, population, supporting numbers)
Summary · context
We present the case of a 50-year-old woman with longstanding, debilitating reactive hypoglycaemia who experienced marked symptomatic and biochemical improvement following treatment with semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
Show in the study text Report a problemFND-4260535703

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Version history

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Version 2Current
11 Oct 2026, 00:04 UTC
Study results updated
Version 1
9 Oct 2026, 03:06 UTC
First added · source update from Europe PMC

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