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Endocrine Abstracts (2016) 41 EP813 | DOI: 10.1530/endoabs.41.EP813

Endocrinology, Diabetes and Metabolism Department of Coimbra University Hospital Centre, Coimbra, Portugal.

Introduction: Neuroglucopenic hypoglycaemia might be an underestimated threat of bariatric surgery, as Roux-en-Y gastric bypass (RYBG) or gastric sleeve. We aimed to evaluate glucose variability after bariatric surgery by continuous glucose monitoring (CGM) in a real-life setting.

Methods: CGM was used in twelve patients with clinical suspicion of hypoglycaemia after undergoing bariatric surgery (RYBG or sleeve), during seven days. CGM was through using iProTM2 CGM device (Medtronic, Northridge, CA) in all patients.

Results: Continuous glucose monitoring retrieved a total of 21 960 glucose data points that were evaluated herein. Ten of the 12 patients (83.3%) had previously undergone RYBG surgery and only 2 (16.7%) had undergone gastric sleeve, with a mean time after surgery of 3.25±1.54 years. All patients had at least one episode of hypoglycaemia below 55 mg/dL (min 3; max 33). Total hypoglycaemia exposure was 11.79 hours per patient and CGM. During the monitoring period, 157(81.35%) out of 193 hypoglycaemic episodes, occurred in the post-prandial state. Glucose variability was evaluated by MAGE (3.205; RV 0.0–2.8), CONGA (3.955; RV 3.6–5.5), J-Index (10.94; RV 4.7–23.6) and SD (1.085; RV 0.0–3.0). Area under the curve for glucose <70 mg/dL was 1.025 and for glucose >180 mg/dL was 1.69.

Conclusions: Glucose variability is exaggerated after bariatric surgery: hypoglycaemia occurred mostly in the post-prandial period and glucose variability was increased by glucose fluctuations, as evidenced by MAGE. As a result, CGM may be a valuable diagnostic tool and may have a role evaluating treatment response to dietary modifications, drug therapy or surgical reintervention.

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