Continuous glucose monitoring in the management of patients after gastric bypass
In patients with gastric bypass (GB), high glucose variability (GV) and hypoglycemia have been demonstrated, which could impact the metabolic status and eating behavior. We describe the glucose patterns determined through continuous glucose monitoring (CGM) in two patients with >5 years follow-up...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2019-07-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM18-0155.xml |
| _version_ | 1818138445950746624 |
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| author | Marcela Rodríguez Flores Ruth Carmina Cruz Soto Verónica Vázquez Velázquez Reina Ruth Soriano Cortés Carlos Aguilar Salinas Eduardo García García |
| author_facet | Marcela Rodríguez Flores Ruth Carmina Cruz Soto Verónica Vázquez Velázquez Reina Ruth Soriano Cortés Carlos Aguilar Salinas Eduardo García García |
| author_sort | Marcela Rodríguez Flores |
| collection | DOAJ |
| description | In patients with gastric bypass (GB), high glucose variability (GV) and hypoglycemia have been demonstrated, which could impact the metabolic status and eating behavior. We describe the glucose patterns determined through continuous glucose monitoring (CGM) in two patients with >5 years follow-up after GB and significant weight recovery, who reported hypoglycemic symptoms that interfered with daily activities, and their response to a nutritional and psycho-educative prescription. Case 1: A 40-year-old woman without pre-surgical type 2 diabetes (T2DM) and normal HbA1c, in whom CGM showed high GV and hypoglycemic episodes that did not correlate with the time of hypoglycemic symptoms. Her GV reduced after prescription of a diet with low glycemic index and modification of meal patterns. Case 2: A 48-year-old male with pre-surgical diagnosis of T2DM and current normal HbA1c, reported skipping meals. The CGM showed high GV, 15% of time in hypoglycemia and hyperglycemic spikes. After prescription of a low glycemic index diet, his GV increased and time in hypoglycemia decreased. Through the detailed self-monitoring needed for CGM, we discovered severe anxiety symptoms, consumption of simple carbohydrates and lack of meal structure. He was referred for more intensive psychological counseling. In conclusion, CGM can detect disorders in glucose homeostasis derived both from the mechanisms of bariatric surgery, as well as the patient’s behaviors and mental health, improving decision-making during follow-up. |
| first_indexed | 2024-12-11T10:12:19Z |
| format | Article |
| id | doaj.art-7302c8c8bc7946ab9bbcef6a945fa6b8 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-12-11T10:12:19Z |
| publishDate | 2019-07-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-7302c8c8bc7946ab9bbcef6a945fa6b82022-12-22T01:11:42ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732019-07-01111610.1530/EDM-18-0155Continuous glucose monitoring in the management of patients after gastric bypassMarcela Rodríguez Flores0Ruth Carmina Cruz Soto1Verónica Vázquez Velázquez2Reina Ruth Soriano Cortés3Carlos Aguilar Salinas4Eduardo García García5Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoNutrition and Obesity Center, Centro Médico ABC, Mexico City, MexicoObesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoObesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoMetabolic Diseases Research Unit, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico; Endocrinology and Metabolism Department, Instituto Tecnológico de Estudios Superiores de Monterrey Tec Salud, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoObesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, MexicoIn patients with gastric bypass (GB), high glucose variability (GV) and hypoglycemia have been demonstrated, which could impact the metabolic status and eating behavior. We describe the glucose patterns determined through continuous glucose monitoring (CGM) in two patients with >5 years follow-up after GB and significant weight recovery, who reported hypoglycemic symptoms that interfered with daily activities, and their response to a nutritional and psycho-educative prescription. Case 1: A 40-year-old woman without pre-surgical type 2 diabetes (T2DM) and normal HbA1c, in whom CGM showed high GV and hypoglycemic episodes that did not correlate with the time of hypoglycemic symptoms. Her GV reduced after prescription of a diet with low glycemic index and modification of meal patterns. Case 2: A 48-year-old male with pre-surgical diagnosis of T2DM and current normal HbA1c, reported skipping meals. The CGM showed high GV, 15% of time in hypoglycemia and hyperglycemic spikes. After prescription of a low glycemic index diet, his GV increased and time in hypoglycemia decreased. Through the detailed self-monitoring needed for CGM, we discovered severe anxiety symptoms, consumption of simple carbohydrates and lack of meal structure. He was referred for more intensive psychological counseling. In conclusion, CGM can detect disorders in glucose homeostasis derived both from the mechanisms of bariatric surgery, as well as the patient’s behaviors and mental health, improving decision-making during follow-up.https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM18-0155.xml |
| spellingShingle | Marcela Rodríguez Flores Ruth Carmina Cruz Soto Verónica Vázquez Velázquez Reina Ruth Soriano Cortés Carlos Aguilar Salinas Eduardo García García Continuous glucose monitoring in the management of patients after gastric bypass Endocrinology, Diabetes & Metabolism Case Reports |
| title | Continuous glucose monitoring in the management of patients after gastric bypass |
| title_full | Continuous glucose monitoring in the management of patients after gastric bypass |
| title_fullStr | Continuous glucose monitoring in the management of patients after gastric bypass |
| title_full_unstemmed | Continuous glucose monitoring in the management of patients after gastric bypass |
| title_short | Continuous glucose monitoring in the management of patients after gastric bypass |
| title_sort | continuous glucose monitoring in the management of patients after gastric bypass |
| url | https://edm.bioscientifica.com/view/journals/edm/2019/1/EDM18-0155.xml |
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