Endocrine, Cardiovascular & Metabolic Research, Unit for Multidisciplinary Research in Biomedicine (UMIB), University of Porto, Jorge Viterbo Ferreira 228, Ed.1, 3rd Floor, 4050-313, Porto, Portugal.
Department of Anatomy, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Jorge Viterbo Ferreira 228, Ed.1, 3rd Floor, 4050-313, Porto, Portugal.
Sci Rep. 2020 Jul 6;10(1):11061. doi: 10.1038/s41598-020-68029-8.
Our aim was to assess the potential of flash glucose monitoring (FGM) for diagnostic workup of suspected post-bariatric hypoglycaemia (PBH). Patients (N = 13) with suspected PBH underwent a food and symptoms diary (FSD) record along with FGM over 14 days. Targeted data analysis confirmed the occurrence of low glucose events in parallel to meal-triggered symptoms. Glycaemic variability, as assessed by Mean Absolute Glucose change (MAG change), was increased, while a higher risk of glycaemic excursions towards both hyper and hypoglycaemia (ADRRGT) was observed in those with more frequent and severe hypoglycaemia. The herein described hypoglycaemia risk index (LBGIGT) with a cut-off value of 4.6 showed to have 100% sensitivity and 100% specificity for PBH. This pilot proof-of-concept study highlighted that FSD coupled with FGM followed by targeted data analysis, provides relevant insights towards PBH diagnosis and grading in a user-friendly and easy to implement study protocol. Furthermore, LBGIGT demonstrated to be an excellent index for PBH diagnosis. The unexpected improvement of glucose profile noticed along the monitoring time also unravels a possible application for PBH management.
我们的目的是评估即时血糖监测（FGM）在疑似减重术后低血糖症（PBH）诊断中的应用潜力。 13 名疑似 PBH 的患者进行了为期 14 天的饮食和症状日记（FSD）记录以及 FGM。通过靶向数据分析证实，低血糖事件与餐时触发的症状同时发生。血糖变异性（MAG 变化）增加，而在低血糖更频繁和更严重的患者中，血糖向高血糖和低血糖（ADRRGT）波动的风险更高。本文描述的低血糖风险指数（LBGIGT）以 4.6 为截断值，对 PBH 的灵敏度和特异性均为 100%。这项初步概念验证研究强调，FSD 与 FGM 相结合，并进行靶向数据分析，可以为 PBH 诊断和分级提供相关见解，同时采用用户友好且易于实施的研究方案。此外，LBGIGT 被证明是诊断 PBH 的一个极好的指标。监测期间发现的血糖谱的意外改善也揭示了其在 PBH 管理中的可能应用。
