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Flash glucose: Diagnosis of post-bariatric hypoglycemia

Elise Macy

Our goal was to evaluate the use of Flash Glucose Monitoring (FGM) in the diagnosis of probable Post-Bariatric Hypoglycaemia (PBH). Over a 14-day period, patients (N=13) with suspected PBH completed a Food and Symptoms Diary (FSD) as well as FGM. Targeted data analysis revealed the presence of low glucose episodes in conjunction with meal-related symptoms. Glycaemic variability was enhanced, as measured by Mean Absolute Glucose Change (MAG change), and individuals with more frequent and severe hypoglycaemia had a greater risk of glycaemic excursions towards both hyper and hypoglycaemia [1]. The hypoglycaemia risk index presented herein has 100% sensitivity and 100% specificity for PBH with a cut-off value of 4.6. This pilot proof-of-concept study demonstrated that FSD combined with FGM, followed by focused data analysis, gives pertinent insights into PBH diagnosis and grading in a user-friendly and simple-to-implement study procedure. In addition, LBGIFGMGT proved to be a good indicator for PBH diagnosis. The unexpected improvement in glucose profile seen throughout the course of the monitoring period hints to a prospective use for PBH treatment.

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