Glycaemic variability assessed by continuous glucose monitoring after Roux-en-Y gastric bypass vs. sleeve gastrectomy

2021 ◽  
Author(s):  
Kleopatra Alexiadou ◽  
Khalefah Malallah ◽  
Ibiyemi Ilesanmi ◽  
Yasmin Tabbakh ◽  
Julia Kenkre ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycaemic Variability

scholarly journals Continuous Glucose Monitoring in Bariatric Patients Undergoing Laparoscopic Sleeve Gastrectomy and Laparoscopic Roux-En-Y Gastric Bypass

2019 ◽  
Vol 29 (4) ◽  
pp. 1317-1326 ◽  
Author(s):  
Michał Wysocki ◽  
Magdalena Szopa ◽  
Tomasz Stefura ◽  
Alicja Dudek ◽  
Grzegorz Torbicz ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Bariatric Patients

Continuous glucose monitoring in acute stroke

2019 ◽  
Author(s):  
Laura Aponte-Becerra ◽  
Rodrigo Quispe ◽  
Laura Mendez-Pino ◽  
Vera Novak ◽  
Magdy Selim ◽  
...  
Keyword(s):  
Standard Deviation ◽  
Acute Stroke ◽  
Continuous Glucose Monitoring ◽  
Poor Prognosis ◽  
Glucose Monitoring ◽  
Mean Amplitude ◽  
P Value ◽  
Stroke Patients ◽  
Glycaemic Variability ◽  
Acute Brain Ischemia

"Hyperglycaemia upon admission is a pathophysiological response to acute brain ischemia that has been independently associated with high mortality rate and poor prognosis. Glycaemic variability (GV) has also shown association with poor clinical outcomes among stroke patients. GV is best assessed by continuous glucose monitoring (CGM), which enables consecutives glucose measurements every 5 minutes. This pilot study aimed: 1) To describe safety, feasibility and tolerability of CGM in the acute stroke setting; and 2) To compare CGM and conventional FS glucose-based monitoring regimen in terms of their relationship with GUA and the accuracy of hypoglycaemic episodes detection. Safety, feasibility and tolerability of CGM was excellent in our cohort of 23 patients with acute stroke (61% ischemic and 39% intracerebral haemorrhage) and there were no adverse events. CGM recorded ten hypoglycaemic episodes that were not detected by conventional FS monitoring. GUA was associated with coefficient of variation (CV) of CGM (p=0.03), CV of FS (p=0.01), standard deviation (SD) of CGM (p-value=0.01) and mean amplitude of glucose excursions (MAGE) (pvalue= 0.001)."

Utility of Continuous Glucose Monitoring vs. Meal Study in Detecting Hypoglycemia After Gastric Bypass

2021 ◽  
Author(s):  
Henri Honka ◽  
Janet Chuang ◽  
David D’Alessio ◽  
Marzieh Salehi
Keyword(s):  
Gastric Bypass ◽  
Continuous Glucose Monitoring ◽  
Gastric Bypass Surgery ◽  
Late Complication ◽  
Glucose Monitoring ◽  
Glucose Variability ◽  
Postprandial Glucose ◽  
Healthy Weight ◽  
Free Living ◽  
Carbohydrate Ingestion

Abstract Context Gastric bypass (GB) increases postprandial glucose excursion, which in turn can predispose to the late complication of hypoglycemia. Diagnosis remains challenging and requires documentation of symptoms associated with low glucose, and relief of symptom when glucose is normalized (Whipple’s triad). Objective To compare the yield of mixed meal test (MMT) and continuous glucose monitoring system (CGMS) in detecting hypoglycemia after gastric bypass surgery (GB). Setting The study was conducted at General Clinical Research Unit, Cincinnati Children’s Hospital (Cincinnati, OH, United States). Methods Glucose profiles were evaluated in 15 patients with documented recurrent clinical hypoglycemia after GB, 8 matched asymptomatic GB subjects, and 9 healthy weight-matched non-operated controls using MMT in a control setting and CGMS under free-living conditions. Results Patients with prior GB had larger glucose variability during both MMT and CGMS when compared to non-surgical controls regardless of their hypoglycemic status. Sensitivity (71 vs. 47 %) and specificity (100 vs. 88 %) of MMT in detecting hypoglycemia was superior to CGMS. Conclusions Our findings indicate that a fixed carbohydrate ingestion during MMT is a more reliable test to diagnose GB-related hypoglycemia compared to CGMS during free-living state.

scholarly journals Continuous Glucose Monitoring for Evaluation of Glycemic Excursions after Gastric Bypass

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Florencia Halperin ◽  
Mary Elizabeth Patti ◽  
Megan Skow ◽  
Muhammad Bajwa ◽  
Allison B. Goldfine
Keyword(s):  
Gastric Bypass ◽  
Continuous Glucose Monitoring ◽  
Rare Complication ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
Hyperinsulinemic Hypoglycemia ◽  
History Of ◽  
Clinically Significant ◽  
Asymptomatic Subjects ◽  
Tolerance Testing

Background. Hyperinsulinemic hypoglycemia with neuroglycopenia is a rare complication of Roux-en-Y gastric bypass (RYGB). We hypothesized that continuous glucose monitoring (CGM) would be useful to characterize glycemic variability after RYGB.Methods. CGM and mixed meal tolerance testing (MMTT) were performed on sixteen post-RYGB subjects, ten with a history of neuroglycopenia on medical treatment and six asymptomatic controls.Results. 9 of 10 subjects with neuroglycopenia developed hypoglycemia defined by glucose <70 mg/dL on CGM, and 3 of 9 on MMTT. In asymptomatic subjects, 3 of 6 had asymptomatic hypoglycemia during CGM, and 3 of 5 on MMTT. Therefore, the sensitivity and specificity to detect clinically significant hypoglycemia was 90% and 50% for CGM and 33% and 40% for MMTT.Conclusions. Asymptomatic hypoglycemia after RYGB is more frequent than commonly recognized. For clinicians evaluating patients for postbypass neuroglycopenia, CGM may be a valuable diagnostic tool.

scholarly journals Glycaemic Variability and Risk Factors of Pregnant Women with and without Gestational Diabetes Mellitus Measured by Continuous Glucose Monitoring

2021 ◽  
Vol 18 (7) ◽  
pp. 3402
Author(s):  
Martina Gáborová ◽  
Viera Doničová ◽  
Ivana Bačová ◽  
Mária Pallayová ◽  
Martin Bona ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Glycaemic Control ◽  
Gestational Diabetes ◽  
Gestational Diabetes Mellitus ◽  
Pregnant Women ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Target Range ◽  
Glycaemic Variability

Background: The aim of the study was to compare the continuous glucose monitoring (CGM)-determined glycaemic variability (GV) of pregnant women with gestational diabetes mellitus (GDM) and without GDM (CG; control group). The secondary aim was to evaluate the association between risk factors of diabetes in pregnancy and parameters of glyceamic control. Methods: Demographic, biometric and biochemical parameters were obtained for pregnant women (20–38 years old) who after an oral glucose tolerance test were examined by 7-day continuous glucose monitoring using a iPro®2 Professional CGM. Results: The differences in GV between women with GDM and CG compared by total area under glucose curve (total AUC, (mmol·day/L) was statistically significant (p = 0.006). Other parameters of glycaemic control such as mean glucose, standard deviation, coefficient of variation, J-index, % time-above target range 7.8 mmol/L (%TAR), % time-in range 3.5–7.8 mmol/L (%TIR), time-below target range 3.5 mmol/L (%TBR), glycated haemoglobin were not significantly different in the study groups. Risk factors (a family history of diabetes, pre-pregnancy BMI, higher weight gain and age) correlated with parameters of glycaemic control. Conclusions: We found a significant difference in GV of women with and without GDM by total AUC determined from CGM. TIR metrics were close to significance. Our work points at an increased GV in relation to the risk factors of GDM. Pregnant women with risk factors have higher probability of severe GV with its consequences on maternal and fetal health state.

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