Tirzepatide for treatment of postbariatric hypoglycemia after Roux-en-Y gastric bypass: a report of 3 cases.

A three-patient case series, so this sits low on the evidence ladder, but postbariatric hypoglycemia has few good options and the use of continuous glucose metrics (time in range, variability) gives the observations some objectivity. It is also mechanistically counterintuitive — incretin agonism might be expected to worsen post-meal insulin surges, not blunt them — which makes the finding worth flagging. Controlled studies and dosing work are needed, as the authors acknowledge.