continuous glucose monitoring for evaluation of glycemic excursions after gastric bypass连续葡萄糖监测评价胃旁路手术后血糖远足.pdfVIP

Hindawi Publishing Corporation Journal of Obesity Volume 2011, Article ID 869536, 7 pages doi:10.1155/2011/869536 Research Article Continuous Glucose Monitoring for Evaluation of Glycemic Excursions after Gastric Bypass Florencia Halperin,1, 2, 3 Mary Elizabeth Patti,2, 3 Megan Skow,2 Muhammad Bajwa,2 and Allison B. Goldfine1, 2, 3 1 Brigham and Women’s Hospital, Boston 02115 , MA, USA 2 Joslin Diabetes Center, Boston, MA 02215, USA 3 Harvard Medical School, Boston 02115 , MA, USA Correspondence should be addressed to Allison B. Goldfine, allison.goldfine@ Received 4 November 2010; Accepted 13 January 2011 Academic Editor: Eric Doucet Copyright © 2011 Florencia Halperin et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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 fr