GLP1R-imaging in Post-RYGB Hypoglycemia

Inclusion Criteria: * Signed informed consent Patients: \- Persisting hyperinsulinemic hypoglycemia after a low-carbohydrate diet and/or insulin suppressive medication for one year. Controls: * RYGB at least 2 years ago * Normal glucose levels before and after RYGB (fasting glucose between 4 and 6 mmol/l or HbA1c between 20 and 42 mmol/mol) * Score ≤ 7 on Sigstad's scoring system (Table 1) * Hypoglycemia excluded by 14-day continuous glucose monitoring * Individual matched to HH group on age (± 5 years), sex and BMI at time of inclusion (± 2 kg/m2) Exclusion Criteria: * Anti-diabetic medication in the past 6 months * Treatment with synthetic Exendin (Exenatide, Byetta®) or Dipeptidyl-Peptidase IV inhibitors in the past six months. * Known liver failure or serum liver values over 2 times normal value at the time of standard laboratory assessment. Normal values of total bilirubin, γ-GT, ASAT and albumin are \<21 μmol, \<40 U/l, \<30 U/l and 35-50 g/l respectively * Pregnancy or the wish to become pregnant within 6 months * Breast feeding * Kidney failure, i.e. calculated creatinine clearance below 40 ml/min * Age \< 18 years * No signed informed consent