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Continuous glucose monitoring in patients with remission of type 2 diabetes after laparoscopic sleeve gastrectomy without or with duodenojejunal bypass
Author(s) -
Sawada Shojiro,
Kodama Shinjiro,
Tsuchiya Satoko,
Kurosawa Satoko,
Endo Akira,
Sugawara Hiroto,
Hosaka Shinichiro,
Kawana Yohei,
Asai Yoichiro,
Yamamoto Junpei,
Munakata Yuichiro,
Izumi Tomohito,
Takahashi Kei,
Kaneko Keizo,
Imai Junta,
Imoto Hirofumi,
Tanaka Naoki,
Naitoh Takeshi,
Ishigaki Yasushi,
Katagiri Hideki
Publication year - 2020
Publication title -
clinical obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.64
H-Index - 12
eISSN - 1758-8111
pISSN - 1758-8103
DOI - 10.1111/cob.12409
Subject(s) - medicine , diabetes mellitus , type 2 diabetes , gastric bypass , sleeve gastrectomy , surgery , hypoglycemia , ambulatory , type 1 diabetes , weight loss , obesity , endocrinology
Summary Bariatric surgery is associated with a high remission rate of type 2 diabetes mellitus. However, it is unclear whether patients showing remission of diabetes actually have normal blood glucose levels throughout the day. We therefore performed continuous glucose monitoring (CGM) in 15 ambulatory patients showing remission of diabetes after laparoscopic sleeve gastrectomy (LSG) without or with duodenojejunal bypass (DJB) at the time of diabetic remission (12.9 ± 1.8 months after bariatric surgery). The definition of remission of diabetes was based on the American Diabetes Association criteria. The mean, SD, and coefficient of variation (CV) of glucose calculated from CGM were 6.2 ± 0.6 mmol/L, 1.5 ± 0.4 mmol/L, and 23.7 ± 6.2%, respectively. These values were higher than those of healthy participants without diabetes previously reported. The percentages of time spent above 10.0 mmol/L and below 3.9 mmol/L were 2.6 (IQR 0‐5.0)% and 0 (IQR 0‐8.0)%, respectively. Thus, patients with remission of diabetes after LSG or LSG/DJB still had substantial periods of hyperglycemia and hypoglycemia throughout the day. Therefore, we must manage patients with diabetes carefully, even after apparent remission of type 2 diabetes in response to bariatric surgery.