Rate of post-bariatric hypoglycemia using continuous glucose monitoring: A meta-analysis of literature studies

Hypoglycemia is a serious complication of bariatric surgery. The aim of the present meta-analysis was to evaluate the rate and the timing of post-bariatric hypoglycemia (PBH) with different bariatric procedures using reliable data from continuous glucose monitoring (CGM). Studies were systematically...

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Published in:Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2022-01, Vol.32 (1), p.32-39
Main Authors: Lupoli, Roberta, Lembo, Erminia, Rainone, Carmen, Schiavo, Luigi, Iannelli, Antonio, Di Minno, Matteo N.D., Capaldo, Brunella
Format: Article
Language:English
Subjects:
Bariatric surgery
Blood Glucose
Blood Glucose Self-Monitoring - adverse effects
Continuous glucose monitoring
Gastrectomy - adverse effects
Gastric Bypass - adverse effects
Humans
Hypoglycemia
Hypoglycemia - diagnosis
Hypoglycemia - etiology
Obesity
Obesity, Morbid - complications
Obesity, Morbid - diagnosis
Obesity, Morbid - surgery
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Summary:Hypoglycemia is a serious complication of bariatric surgery. The aim of the present meta-analysis was to evaluate the rate and the timing of post-bariatric hypoglycemia (PBH) with different bariatric procedures using reliable data from continuous glucose monitoring (CGM). Studies were systematically searched in the Web of Science, Scopus and PubMed databases according to Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. The prevalence of PBH was expressed as weighted mean prevalence (WMP) with pertinent 95% confidence intervals (95%CI). A total of 8 studies (16 datasets) enrolling 280 bariatric subjects were identified. The total WMP of PBH was 54.3% (95%CI: 44.5%–63.8%) while the WMP of nocturnal PBH was 16.4% (95%CI: 7.0%–34%). We found a comparable rate of PBH after Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) (OR 1.62, 95%CI: 0.71–3.7; P = 0.248); likewise, the percent time spent in hypoglycemia was similar with the two procedures (mean difference 5.3%, 95%CI: −1.4%–12.0%; P = 0.122); however, RYGB was characterized by a higher glycemic variability than SG. Regression models showed that the time elapsed from surgical intervention was positively associated with a higher rate of both total PBH (Z-value: 3.32, P 
ISSN:0939-4753
1590-3729
DOI:10.1016/j.numecd.2021.08.047