ESPE Abstracts (2014) 82 P-D-3-3-751

ESPE2014 Poster Category 3 Diabetes (4) (12 abstracts)

Continuous Glucose Monitoring vs Oral Glucose Tolerance Test and HbA1C in the Evaluation of Glycemic Abnormalities in an Obese Adolescent Before vs After Partial Gastrectomy

Ashraf Soliman , Aml Sabt , Fawzia Alyafei & Nagwa Eldarsy

Hamad General Hospital, Doha, Qatar

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.

Table 1.
Normal valuesBefore surgery8 weeks after surgery
Mean blood glucose (MBG) for 24 h<1179278
BG 1 h before breakfast<1088969
BG 1 h before lunch<1139970
BG 1 h before dinner<10810174
MBG 3 h after breakfast<12610581
MBG 3 h after lunch<12114569
MBG 3 h after dinner<126162130
S.D. of blood glucose (SDBG)<254217
Number of high excursions/day020
The % of time > 7.8<9190
OGTT – 0 h<111121109
OGTT – 2 h<140225140
HbA1c %<69.106.70

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.

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