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Impact of hypoglycemia after gastrectomy on Global Leader Initiative on Malnutrition-defined malnutrition: a retrospective study

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Abstract

Purpose

The Global Leader Initiative on Malnutrition (GLIM) criteria were developed in 2018 as a global indicator of malnutrition, and the term ‘malnutrition-sarcopenia syndrome’ was established. Recently, it has been reported that fluctuations in blood glucose are related to sarcopenia. In this study, we investigated the effects of glucose fluctuations on malnutrition after gastrectomy using a continuous glucose monitoring (CGM) device.

Methods

We analyzed the data of 69 patients with gastric cancer (GC) who underwent curative gastrectomy between November 2017 and December 2020. CGM was performed over a 2-week period at 1 month and 1 year after surgery. The GLIM criteria included weight loss, the body mass index (BMI), and the psoas muscle mass index (PMI).

Results

One year after surgery, 25 and 35 patients had severe and moderate malnutrition, respectively. The time below range (TBR) (percent of time the glucose concentration was < 70 mg/dL) and nocturnal (00:00–06:00) TBR were significantly higher in the severe malnutrition group than in the other groups (TBR: normal/moderate 17.9% vs. severe 21.6%, P = 0.039, nocturnal TBR; normal/moderate 30.6% vs. severe 41.1%, P = 0.034).

Conclusions

Post-gastrectomy hypoglycemia, including long nocturnal hypoglycemia, was higher in severely malnourished patients than in other patients even 1 year after surgery. Prevention of nocturnal hypoglycemia may be the key to improving malnutrition following gastrectomy.

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Funding

This study did not receive specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-Cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, 602-8566, Japan

    Keiji Nishibeppu, Takeshi Kubota, Masayuki Yubakami, Takuma Ohashi, Jun Kiuchi, Hiroki Shimizu, Tomohiro Arita, Yusuke Yamamoto, Hirotaka Konishi, Ryo Morimura, Atsushi Shiozaki, Hisashi Ikoma, Yoshiaki Kuriu, Hitoshi Fujiwara & Eigo Otsuji

Authors
  1. Keiji Nishibeppu
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  2. Takeshi Kubota
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  3. Masayuki Yubakami
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  4. Takuma Ohashi
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  5. Jun Kiuchi
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Corresponding author

Correspondence to Takeshi Kubota.

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The authors declare no conflicts of interest.

Ethics approval and consent to participate

This study was designed in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Kyoto Prefectural University of Medicine (ERB-C-975–2). All patients received a sufficient explanation of the study, and written informed consent was obtained from all patients.

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Nishibeppu, K., Kubota, T., Yubakami, M. et al. Impact of hypoglycemia after gastrectomy on Global Leader Initiative on Malnutrition-defined malnutrition: a retrospective study. Surg Today (2024). https://doi.org/10.1007/s00595-024-02799-w

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