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.

863-P: In Patients without Diabetes, Glycemic Variability Derived from Continuous Glucose Monitoring (CGM) Data Relates to Hyperglycemia More Than Insulin Resistance

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 863-P
Author(s):  
YUAN ZHANG ◽  
EVAN A. OLAWSKY ◽  
ALISON C. ALVEAR ◽  
LYNN E. EBERLY ◽  
LISA S. CHOW
Keyword(s):  
Insulin Resistance ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability

Glycemic Variability and Insulin Needs in Patients with Type 1 Diabetes Mellitus Supplemented with Vitamin D: A Pilot Study Using Continuous Glucose Monitoring System

2018 ◽  
Vol 14 (4) ◽  
pp. 395-403 ◽  
Author(s):  
Karem Mileo Felício ◽  
Ana Carolina Contente Braga de Souza ◽  
Joao Felicio Abrahao Neto ◽  
Franciane Trindade Cunha de Melo ◽  
Carolina Tavares Carvalho ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Vitamin D ◽  
Type 1 Diabetes ◽  
Pilot Study ◽  
Type 1 Diabetes Mellitus ◽  
Monitoring System ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability

scholarly journals Enlarged glycemic variability in sulfonylurea-treated well-controlled type 2 diabetics identified using continuous glucose monitoring

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fumi Uemura ◽  
Yosuke Okada ◽  
Keiichi Torimoto ◽  
Yoshiya Tanaka
Keyword(s):  
Glucose Level ◽  
Continuous Glucose Monitoring ◽  
Glucose Monitoring ◽  
Glycemic Variability ◽  
High Dose ◽  
Type 2 Diabetics ◽  
Time In Range ◽  
The Difference ◽  
Glycated Hemoglobin Level

AbstractTime in range (TIR) is an index of glycemic control obtained from continuous glucose monitoring (CGM). The aim was to compare the glycemic variability of treatment with sulfonylureas (SUs) in type 2 diabetes mellitus (T2DM) with well-controlled glucose level (TIR > 70%). The study subjects were 123 patients selected T2DM who underwent CGM more than 24 h on admission without changing treatment. The primary endpoint was the difference in glycemic variability, while the secondary endpoint was the difference in time below range < 54 mg/dL; TBR < 54, between the SU (n = 63) and non-SU (n = 60) groups. The standard deviation, percentage coefficient of variation (%CV), and maximum glucose level were higher in the SU group than in the non-SU group, and TBR < 54 was longer in the high-dose SU patients. SU treatment was identified as a significant factor that affected %CV (β: 2.678, p = 0.034). High-dose SU use contributed to prolonged TBR < 54 (β: 0.487, p = 0.028). Our study identified enlarged glycemic variability in sulfonylurea-treated well-controlled T2DM patients and high-dose SU use was associated with TBR < 54. The results highlight the need for careful adjustment of the SU dose, irrespective of glycated hemoglobin level or TIR value.

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.

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