RT Journal Article
T1 Mixed Meal Tolerance Test Versus Continuous Glucose Monitoring for an Effective Diagnosis of Persistent Post-Bariatric Hypoglycemia
A1 Ramos-Levi, Ana
A1 Marcuello, Clara
A1 Rubio Herrera, Miguel Ángel
A1 Matía Martín, María Del Pilar
A1 Pérez Ferré, Natalia
A1 Sánchez Pernaute, Andrés
A1 Torres García, Antonio José
A1 Calle Pascual, Alfonso Luis
AB Gastric bypass determines an increase in incretin secretion and glucose excursions throughout the day and may sometimes entail the development of severe post-bariatric hypoglycemia (PBH). However, there is no consensus on the gold standard method for its diagnosis. In this study, we evaluated the usefulness of a mixed meal tolerance test (MMTT) and continuous glucose monitoring (CGM) for the diagnosis of PBH, defined as glucose levels <54 mg/dL (3.0 mmol/L). We found that hypoglycemia occurred in 60% of patients after the MMTT and in 75% during CGM, and it was predominantly asymptomatic. The MMTT confirmed the diagnosis of PBH in 88.9%of patients in whom surgery had been performed more than three years ago, in comparison to 36.4% in cases with a shorter postsurgical duration. CGM diagnosed nocturnal asymptomatic hypoglycemia in 70% of patients, and daytime postprandial hypoglycemia in 25% of cases. The mean duration of asymptomatic hypoglycemia was more than 30 min a day. Patients with ≥2% of their CGM readings with hypoglycemia exhibited a higher degree of glucose variability than those with <1% of the time in hypoglycemia. Our results show that the MMTT may be a useful dynamic test to confirm the occurrence of hypoglycemia in a large number of patients with persistent and recurrent PBH during long-term follow-up after gastric bypass. CGM, on its part, helps identify hypoglycemia in the real-world setting, especially nocturnal asymptomatic hypoglycemia, bringing to light that PBH is not always postprandial.
PB MPDI
YR 2023
FD 2023-06-27
LK https://hdl.handle.net/20.500.14352/103573
UL https://hdl.handle.net/20.500.14352/103573
LA eng
NO Ramos-Levi, A.M.; Rubio-Herrera, M.A.; Matía-Martín, P.; Pérez-Ferre, N.; Marcuello, C.; Sánchez-Pernaute, A.; Torres-García, A.J.; Calle-Pascual, A.L. Mixed Meal Tolerance Test Versus Continuous Glucose Monitoring for an Effective Diagnosis of Persistent Post-Bariatric Hypoglycemia. J. Clin. Med. 2023, 12, 4295. https://doi.org/10.3390/jcm12134295
NO Fundación de Investigación en Nutrición y Metabolismo
NO Fundación de Estudios Metabólicos
DS Docta Complutense
RD 5 abr 2025