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Differences in Anthropometric and Metabolic Parameters Between Subjects with Hypoglycaemia and Subjects with Euglycaemia After an Oral Glucose Tolerance Test Six Months After Laparoscopic Sleeve Gastrectomy

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Abstract

Background

Hypoglycaemia after an oral glucose tolerance test (OGTT) can occur in up to 33 % of subjects after laparoscopic sleeve gastrectomy (LSG). The underlying pathophysiology is not well understood. We aimed to compare the anthropometric and metabolic characteristics of subjects with post-OGTT hypoglycaemia (HYPO) to subjects with post-OGTT euglycaemia (EU) 6 months after LSG.

Methods

Eighteen morbidly obese patients with normal glucose tolerance (NGT) were evaluated with an OGTT before and 6 months after LSG. Serum glucose and insulin were measured before and every 30 min after glucose ingestion up to 120’. The patients were categorized as HYPO or EU based on lowest glucose levels 90’ to 120’ post-OGTT 6 months after LSG (hypoglycaemia defined as glucose levels <60 mg/dl). OGTT derived indices of insulin secretion; insulin sensitivity and beta cell function were also evaluated.

Results

Eight patients (44.4 %) were categorized as HYPO. Preoperatively, subjects with HYPO had lower BMI (p = 0.02) compared to that with EU. Postoperatively, subjects with HYPO had lower BMI (p = 0.01), lower weight (p = 0.01), and higher percentage of total weight loss (%TWL) (p = 0.03) compared to that with EU. The beta cell function index was higher in the HYPO group postoperatively compared to EU (p = 0.02)—especially during the latter portion of the OGTT. No difference was detected in insulin secretion and insulin sensitivity indices between the two groups preoperatively or postoperatively.

Conclusions

Subjects with NGT who developed HYPO 6 months after LSG are leaner, with higher TWL% and higher beta cell function at the latter portion of the OGTT compared to those with EU.

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Authors and Affiliations

  1. Leicester Diabetes Centre, University of Leicester, Leicester, UK

    Dimitris Papamargaritis

  2. Department of Endocrinology, University Hospital of Larissa, Larissa, Greece

    Dimitris Papamargaritis, Alexandra Bargiota & George Koukoulis

  3. Department of Surgery, University Hospital of Larissa, Viopolis, 41110, Larissa, Greece

    Dimitris Zacharoulis, Eleni Sioka, Eleni Zachari & George Tzovaras

Authors
  1. Dimitris Papamargaritis
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  2. Dimitris Zacharoulis
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  3. Eleni Sioka
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  4. Eleni Zachari
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  5. Alexandra Bargiota
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  6. George Koukoulis
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  7. George Tzovaras
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Correspondence to George Tzovaras.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Papamargaritis, D., Zacharoulis, D., Sioka, E. et al. Differences in Anthropometric and Metabolic Parameters Between Subjects with Hypoglycaemia and Subjects with Euglycaemia After an Oral Glucose Tolerance Test Six Months After Laparoscopic Sleeve Gastrectomy. OBES SURG 26, 2747–2755 (2016). https://doi.org/10.1007/s11695-016-2187-z

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