Background: We compared continuous glucose monitoring (CGMS) (Medtronic) to oral glucose tolerance test (OGTT) and HbA1c in the follow-up of glycemic abnormality in an adolescent girl with morbid obesity and glycemic abnormalities before and after 2 months of partial gastrectomy. This 16-year-old adolescent girl presented with obesity (weight 98 kg, height 158 cm, BMI=39.2 kg/m2), acanthosis nigricans and nocturnal polyuria and polydipsia. Trials to reduce weight through dieting, exercise and use of metformin was not successful; (patient lost 3 kg in 4 months). Her fasting BG=102 mg/dl but 2 h BG after oral glucose (75 g)=225 mg/dl. She underwent partial gastrectomy surgery. Two months after surgery her weight=70 kg and BMI=28 kg/m2.
Results: A comparison of her glycemic data using CGMS (for 5 days), OGTT and HbA1c before and 2 months after surgery is shown in Table 1.
|Normal values||Before surgery||8 weeks after surgery|
|Mean blood glucose (MBG) for 24 h||<117||92||78|
|BG 1 h before breakfast||<108||89||69|
|BG 1 h before lunch||<113||99||70|
|BG 1 h before dinner||<108||101||74|
|MBG 3 h after breakfast||<126||105||81|
|MBG 3 h after lunch||<121||145||69|
|MBG 3 h after dinner||<126||162||130|
|S.D. of blood glucose (SDBG)||<25||42||17|
|Number of high excursions/day||0||2||0|
|The % of time > 7.8||<9||19||0|
|OGTT 0 h||<111||121||109|
|OGTT 2 h||<140||225||140|
Conclusion: Before surgery this obese patient with morbid obesity had normal FBG but abnormal OGTT which was confirmed with CGMS criteria. After surgery CGMS showed correction of her glycemia both during basal and postprandial in real-life settings.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology