Evidence map›Paper›PMID 41806840›Full record

Observational studyCell reports. Medicine2026

Plasma GDF15 increases during hyperinsulinemic hypoglycemia in humans with post-bariatric hypoglycemia and after insulin exposure in mice.

Rafael Ferraz-Bannitz, Lei Pei, Hanna Wang, Berkcan Ozturk, Pilar Casanova Querol, Alessandra Gonçalves da Cruz, Tyler M Cook, Hamayle Saeed, Leila Osterwalder, Lindsay Poulos and 8 more

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Cell reports. Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04428866 (Mechanisms of Post-Bariatric Hypoglycemia), which is not on this map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04428866 unknown statusnot on this map

Mechanisms of Post-Bariatric Hypoglycemia

TypeobservationalSponsorJoslin Diabetes CenterRan2020 to 2024Enrolled105ConditionsHypoglycemiaArmsContinuous Glucose Monitoring, activity monitor, Mixed meal tolerance test, Glucagon Sensitivity Testing, Hypoglycemic Hyperinsulinemic Clamp
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Rafael Ferraz-BannitzResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Lei PeiResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Hanna WangResearch Division, Joslin Diabetes Center, Boston, MA, USA.
Berkcan OzturkResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Pilar Casanova QuerolResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Alessandra Gonçalves da CruzResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Tyler M CookSection of Nutrition, Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Hamayle SaeedResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Leila OsterwalderResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Lindsay PoulosResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Hany SaifeldinResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Cameron CummingsResearch Division, Joslin Diabetes Center, Boston, MA, USA.
Maryam FarahmandsadrResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Alessandra AmoreResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Amanda SheehanResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
Donald C SimonsonHarvard Medical School, Boston, MA, USA; Divsion of Endocrinology, Brigham and Women's Hospital, Boston, MA, USA.
Darleen A SandovalSection of Nutrition, Department of Pediatrics, Division of Endocrinology, Diabetes and Metabolism, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Mary-Elizabeth PattiResearch Division, Joslin Diabetes Center, Boston, MA, USA; Harvard Medical School, Boston, MA, USA. Electronic address: mary.elizabeth.patti@joslin.harvard.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Post-bariatric hypoglycemia (PBH), characterized by excessive postprandial incretin and insulin secretion, is a common complication of bariatric surgery. Here, we investigate the relationship between PBH and growth differentiation factor 15 (GDF15) in individuals with PBH after Roux-en-Y gastric bypass (RYGB), post-RYGB individuals who remain asymptomatic (Asx), and individuals with overweight/obesity but without history of surgery (Ow/Ob). Fasting plasma GDF15 is higher in PBH vs. Ow/Ob and further increases postprandially, coinciding with hypoglycemia symptoms. During a hyperinsulinemic hypoglycemic clamp, GDF15 progressively increases in PBH and correlates with hypoglycemia survey symptoms, including weakness, difficulty concentrating, feeling cold, and tingling lips. In mice, insulin-induced hypoglycemia also results in elevated GDF15 levels, and exogenous recombinant GDF15 (rGDF15) reduces food intake in response to hypoglycemia. Our data suggest that GDF15 modulates the counterregulatory response to hypoglycemia in both PBH individuals and mice and that elevated GDF15 levels contribute to hypoglycemia-related postprandial symptoms. This study was registered at ClinicalTrials.gov (NCT04428866).

Indexed as

Bariatric SurgeryGrowth Differentiation Factor 15HyperinsulinismHypoglycemiaInsulinAdultAnimalsBlood GlucoseFemaleGastric BypassHumansMaleMiceMice, Inbred C57BLMiddle AgedBlood GlucoseGDF15 protein, humanGrowth Differentiation Factor 15Insulincounterregulatory responseGDF15hypoglycemiahypoglycemia symptomspost-bariatric hypoglycemia

Identifiers

PMID41806840
PMCPMC13006391

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.