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In this article, we will review incretin physiology and evidence supporting a role of the incretin hormones in the pathophysiology of hyperinsulinemic hypoglycemia, as well as results from proof-of concept studies exploring a therapeutic approach targeting the GLP-1 receptor to treat hyperinsulinemic hypoglycemia

Are uncomfortable with compounded medications: If you have concerns about using medications that haven't undergone FDA review as finished products, or you strongly prefer FDA-approved options for peace of mind, brand-name Wegovy or Zepbound (if you can access them affordably) would be more appropriate than compounded formulations

If you experience any suspected side effects from GLP-1 medications or fibre supplements, report them to the MHRA Yellow Card scheme (yellowcard.mhra.gov.uk)

Compared with other second-line options, DPP-4 inhibitors occupy a middle ground: SGLT-2 inhibitors (e.g., empagliflozin, dapagliflozin) offer similar or slightly greater HbA1c reductions alongside additional cardiovascular and renal benefits