Continuous glucose monitoring in patients with remission of type 2 diabetes after laparoscopic sleeve gastrectomy without or with duodenojejunal bypass
Continuous glucose monitoring in patients with remission of type 2 diabetes after laparoscopic sleeve gastrectomy without or with duodenojejunal bypass
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DOI：
10.1111/cob.12409
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发表时间：
2020-09-06
期刊：
影响因子：
3.3
通讯作者：
Katagiri, Hideki
中科院分区：
文献类型：
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作者：
Sawada, Shojiro;Kodama, Shinjiro;Katagiri, Hideki
减肥手术与2型糖尿病的高缓解率相关。然而，目前尚不清楚显示糖尿病缓解的患者是否实际上全天血糖水平正常。因此，我们对15例在糖尿病缓解时（减肥手术后12.9 +/- 1.8个月），在没有或有十二指肠空肠旁路（DJB）的腹腔镜套管胃切除术（LSG）后糖尿病缓解的门诊患者进行了连续血糖监测（CGM）。糖尿病缓解的定义是基于美国糖尿病协会的标准。CGM计算的葡萄糖均值、SD和变异系数（CV）分别为6.2 +/- 0.6 mmol/L、1.5 +/- 0.4 mmol/L和23.7 +/- 6.2%。这些数值高于之前报道的没有糖尿病的健康参与者。高于10.0 mmol/L和低于3.9 mmol/L的时间百分比分别为2.6 (IQR 0-5.0)%和0 (IQR 0-8.0)%。因此，LSG或LSG/DJB后糖尿病缓解的患者全天仍有大量的高血糖和低血糖期。因此，我们必须谨慎管理糖尿病患者，即使在2型糖尿病明显缓解后，对减肥手术的反应。
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.