Inger Nilsen1,2, Magnus Sundbom3, Niclas Abrahamsson4, Arvo Haenni5. 1. Center for Clinical Research Dalarna, Uppsala University, Nissers vag 3, SE 791 82, Falun, Sweden. inger.nilsen@ltdalarna.se. 2. Department of Food Studies, Nutrition and Dietetics, Uppsala University, Box 560, SE 751 22, Uppsala, Sweden. inger.nilsen@ltdalarna.se. 3. Department of Surgical Sciences, Uppsala University Hospital, SE 751 85, Uppsala, Sweden. 4. Department of Medical Sciences, Uppsala University Hospital, SE 751 85, Uppsala, Sweden. 5. Department of Public Health and Caring Sciences/Clinical Nutrition, Uppsala University, Box 564, SE 752 37, Uppsala, Sweden.
Abstract
BACKGROUND: Bariatric surgery improves glucose homeostasis; however, side effects such as hypoglycemia can occur. We investigated the effects of meals on interstitial glucose (IG) response in biliopancreatic diversion with duodenal switch (BPD-DS) and Roux-en-Y gastric bypass (RYGBP)-operated patients at least 1 year after surgery. METHODS: Thirty patients treated with BPD-DS or RYGBP were recruited at the outpatient Obesity Unit, Uppsala University Hospital. IG was measured by continuous glucose monitoring (CGM) for 3 consecutive days, and postprandial IG levels from 5 to 120 min were analyzed for 2 of these days. All intake of food and beverages was simultaneously registered in a food diary, which was processed using The Meal Pattern Questionnaire. RESULTS: Postprandial IG levels were significantly lower in BPD-DS (n = 14) compared to RYGBP (n = 15)-treated patients, with mean concentrations of 5.0 (± 1.0) and 6.3 (± 1.8) mmol/L respectively (p < 0.001). The mean postprandial IG increment was lower in BPD-DS than in RYGBP patients, 0.2 (± 0.6) vs. 0.4 (± 1.4) mmol/L (p < 0.001). Furthermore, the postprandial IG variability was less pronounced in BPD-DS than in RYGBP patients. The mean number of daily meals did not differ between the two groups, 7.8 (± 2.6) in BPD-DS and 7.2 (± 1.7) in the RYGBP (p = 0.56). CONCLUSION: BPD-DS patients demonstrated lower postprandial IG concentrations, with smaller postprandial IG increments and less pronounced postprandial IG variability compared to RYGBP patients. The two groups had similar meal pattern and the postprandial IG responses is probably associated with differences in postoperative physiology.
BACKGROUND: Bariatric surgery improves glucose homeostasis; however, side effects such as hypoglycemia can occur. We investigated the effects of meals on interstitial glucose (IG) response in biliopancreatic diversion with duodenal switch (BPD-DS) and Roux-en-Y gastric bypass (RYGBP)-operated patients at least 1 year after surgery. METHODS: Thirty patients treated with BPD-DS or RYGBP were recruited at the outpatient Obesity Unit, Uppsala University Hospital. IG was measured by continuous glucose monitoring (CGM) for 3 consecutive days, and postprandial IG levels from 5 to 120 min were analyzed for 2 of these days. All intake of food and beverages was simultaneously registered in a food diary, which was processed using The Meal Pattern Questionnaire. RESULTS: Postprandial IG levels were significantly lower in BPD-DS (n = 14) compared to RYGBP (n = 15)-treated patients, with mean concentrations of 5.0 (± 1.0) and 6.3 (± 1.8) mmol/L respectively (p < 0.001). The mean postprandial IG increment was lower in BPD-DS than in RYGBP patients, 0.2 (± 0.6) vs. 0.4 (± 1.4) mmol/L (p < 0.001). Furthermore, the postprandial IG variability was less pronounced in BPD-DS than in RYGBP patients. The mean number of daily meals did not differ between the two groups, 7.8 (± 2.6) in BPD-DS and 7.2 (± 1.7) in the RYGBP (p = 0.56). CONCLUSION:BPD-DSpatients demonstrated lower postprandial IG concentrations, with smaller postprandial IG increments and less pronounced postprandial IG variability compared to RYGBP patients. The two groups had similar meal pattern and the postprandial IG responses is probably associated with differences in postoperative physiology.
Authors: Ronald Kefurt; Felix B Langer; Karin Schindler; Soheila Shakeri-Leidenmühler; Bernhard Ludvik; Gerhard Prager Journal: Surg Obes Relat Dis Date: 2014-11-13 Impact factor: 4.734
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