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Continuous glucose monitoring in a patient with gastric bypass for morbid obesity and type 2 diabetes mellitus (case report)

https://doi.org/10.17238/2072-3180-2023-50-55

Abstract

Introduction. Bariatric surgery is the most effective method of obesity treatment, improving glycemic control in metabolism disorders. Continuous glucose monitoring (CGM) is shown to be the most informative measurement in diabetes mellitus. There are data in the literature regarding the development of hypoglycemic episodes in the postoperative period. However, there is not enough data in the literature about perioperative CGM. The association of perioperative CGM with further hypoglycaemia requires further study.

Purpose of the study. To evaluate the perioperative CGM in a patient with morbid obesity and type 2 diabetes mellitus during bariatric surgery (gastric bypass).

Materials and methods. A patient with morbid obesity and type 2 diabetes mellitus underwent CGM, including 7 days before and after gastric bypass.

Results: In the first days of the postoperative period, according to CGM data, 5 hypoglycemic episodes with an average duration of 141 minutes were detected. 3 months after the operation, the patient also revealed hypoglycemic episodes.

Conclusion. It is impossible to exclude assotiation between perioperative hypoglycemia on CGM and further glycemic profile in patients after bariatric surgery.

About the Authors

G. V. Semikova
Pavlov First Saint Petersburg State Medical University
Russian Federation

Semikova Galina Vladimirovna – Candidate of Medical Sciences, Assistant of the Department of Faculty Therapy with a course of Endocrinology, Cardiology with the G.F. Lang Clinic, endocrinologist of the Research Institute of CVD NCIC

6–8 Lva Tolstogo str., Saint Petersburg, 197022



V. S. Mozgunova
Pavlov First Saint Petersburg State Medical University
Russian Federation

Mozgunova Valentina Sergeevna – Assistant of the Department of Faculty Therapy with the course of Endocrinology, Cardiology with the G.F. Lang Clinic, endocrinologist of the Research Institute of CVD NCIC

6–8 Lva Tolstogo str., Saint Petersburg, 197022



K. A. Anisimova
Center of Surgical Treatment of Obesity and Metabolic Disorders, Pavlov First Saint Petersburg State Medical University
Russian Federation

Anisimova Kristina Alexandrovna – Surgeon of the Surgical Department No. 2

6–8 Lva Tolstogo str., Saint Petersburg, 197022



Z. M. Hamid
Center of Surgical Treatment of Obesity and Metabolic Disorders, Pavlov First Saint Petersburg State Medical University
Russian Federation

Hamid Zarina Mikhailovna – a surgeon of the Surgical Department No. 2

6–8 Lva Tolstogo str., Saint Petersburg, 197022



E. T. Berulava
Center of Surgical Treatment of Obesity and Metabolic Disorders, Pavlov First Saint Petersburg State Medical University
Russian Federation

Berulava Elena Tristanovna – Laboratory assistant of the Department of Surgical Diseases of the Faculty of Dentistry with a course of Coloproctology

6–8 Lva Tolstogo str., Saint Petersburg, 197022



S. G. Balandov
Center of Surgical Treatment of Obesity and Metabolic Disorders, Pavlov First Saint Petersburg State Medical University
Russian Federation

Stanislav G. Balandov – Candidate of Medical Sciences, Head of Surgical Department No. 2

6–8 Lva Tolstogo str., Saint Petersburg, 197022



D. I. Vasilevsky
Center of Surgical Treatment of Obesity and Metabolic Disorders, Pavlov First Saint Petersburg State Medical University
Russian Federation

Vasilevsky Dmitry Igorevich – MD, Professor, Head of the Department of Surgical Diseases of the Faculty of Dentistry with the course of Coloproctology

6–8 Lva Tolstogo str., Saint Petersburg, 197022



A. R. Volkova
Pavlov First Saint Petersburg State Medical University
Russian Federation

Volkova Anna Ralfovna – MD, Professor of the Department of Faculty Therapy with the course of Endocrinology, Cardiology with the G.F. Lang Clinic 

6–8 Lva Tolstogo str., Saint Petersburg, 197022



References

1. Algorithms of specialized medical care for patients with diabetes mellitus. Edited by I.I. Dedova, M.V. Shestakova, A.Yu. Mayorova. 11th edition. M., 2023. https://doi.org/https://doi.org/10.14341/DM13042

2. Halperin F., Patti M.E., Skow M. et al. Continuous glucose monitoring for evaluation of glycemic excursions after gastric bypass. J Obes., 2011, рр. 869536.

3. Lupoli R., Lembo E., Rainone C. et al. Rate of post-bariatric hypoglycemia using continuous glucose monitoring: A meta-analysis of literature studies. Nutr Metab Cardiovasc Dis., 2022, № ;32(1), рр. 32–39. https://doi.org/10.1016/j.numecd.2021.08.047

4. Lupoli R., Lembo E., Ciciola P. et al. Continuous glucose monitoring in subjects undergoing bariatric surgery: Diurnal and nocturnal glycemic patterns. Nutr Metab Cardiovasc Dis., 2020, Oct 30; № 30(11), рр. 1954–1960. https://doi.org/10.1016/j.numecd.2020.06.029. Epub 2020 Jul 11. PMID: 32807631.


Review

For citations:


Semikova G.V., Mozgunova V.S., Anisimova K.A., Hamid Z.M., Berulava E.T., Balandov S.G., Vasilevsky D.I., Volkova A.R. Continuous glucose monitoring in a patient with gastric bypass for morbid obesity and type 2 diabetes mellitus (case report). Moscow Surgical Journal. 2023:50-55. (In Russ.) https://doi.org/10.17238/2072-3180-2023-50-55

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ISSN 2072-3180 (Print)