Skip to main content
Top
Published in: Diabetologia 1/2017

Open Access 01-01-2017 | Short Communication

Altered glucose profiles and risk for hypoglycaemia during oral glucose tolerance testing in pregnancies after gastric bypass surgery

Authors: Michael Feichtinger, Tina Stopp, Sandra Hofmann, Stephanie Springer, Sophie Pils, Alexandra Kautzky-Willer, Herbert Kiss, Wolfgang Eppel, Andrea Tura, Latife Bozkurt, Christian S. Göbl

Published in: Diabetologia | Issue 1/2017

Login to get access

Abstract

Aims/hypothesis

A history of gastric bypass surgery can influence the results of the OGTT recommended during pregnancy. Therefore, we compared OGTT glucose kinetics and pregnancy outcome between pregnant gastric bypass patients and BMI-matched, lean and obese controls.

Methods

Medical records were used to collect data on glucose measurements during the 2 h 75 g OGTT as well as on pregnancy and fetal outcome for 304 women (n = 76 per group, matched for age and date of delivery).

Results

Women after bariatric surgery had lower fasting glucose levels compared with lean, obese and BMI-matched controls, and showed altered postprandial glucose kinetics, including a rise at 60 min followed by hypoglycaemia with serum glucose of <3.34 mmol/l (which occurred in 54.8%). Moreover, their risk of pre-eclampsia or gestational hypertension was reduced, with an increased risk of delivering small for gestational age infants.

Conclusions/interpretation

Alternative strategies to accurately define impaired glucose metabolism in pregnancies after bariatric surgery should be explored.
Appendix
Available only for authorised users
Literature
1.
go back to reference Metzger BE, Gabbe SG, Persson B et al (2010) International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycaemia in pregnancy. Diabetes Care 33:676–682CrossRefPubMed Metzger BE, Gabbe SG, Persson B et al (2010) International association of diabetes and pregnancy study groups recommendations on the diagnosis and classification of hyperglycaemia in pregnancy. Diabetes Care 33:676–682CrossRefPubMed
2.
go back to reference Cummings DE, Arterburn DE, Westbrook EO et al (2016) Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: the CROSSROADS randomised controlled trial. Diabetologia 59:945–953CrossRefPubMed Cummings DE, Arterburn DE, Westbrook EO et al (2016) Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: the CROSSROADS randomised controlled trial. Diabetologia 59:945–953CrossRefPubMed
3.
go back to reference Dirksen C, Jorgensen NB, Bojsen-Moller KN et al (2012) Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass. Diabetologia 55:1890–1901CrossRefPubMed Dirksen C, Jorgensen NB, Bojsen-Moller KN et al (2012) Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass. Diabetologia 55:1890–1901CrossRefPubMed
4.
go back to reference Rodieux F, Giusti V, D’Alessio DA, Suter M, Tappy L (2008) Effects of gastric bypass and gastric banding on glucose kinetics and gut hormone release. Obesity 16:298–305CrossRefPubMed Rodieux F, Giusti V, D’Alessio DA, Suter M, Tappy L (2008) Effects of gastric bypass and gastric banding on glucose kinetics and gut hormone release. Obesity 16:298–305CrossRefPubMed
5.
go back to reference Johansson K, Cnattingius S, Naslund I et al (2015) Outcomes of pregnancy after bariatric surgery. N Engl J Med 372:814–824CrossRefPubMed Johansson K, Cnattingius S, Naslund I et al (2015) Outcomes of pregnancy after bariatric surgery. N Engl J Med 372:814–824CrossRefPubMed
6.
go back to reference Gonzalez I, Rubio MA, Cordido F et al (2015) Maternal and perinatal outcomes after bariatric surgery: a Spanish multicenter study. Obes Surg 25:436–442CrossRefPubMed Gonzalez I, Rubio MA, Cordido F et al (2015) Maternal and perinatal outcomes after bariatric surgery: a Spanish multicenter study. Obes Surg 25:436–442CrossRefPubMed
7.
go back to reference Carpenter MW (2007) Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes Care 30(Suppl 2):S246–S250CrossRefPubMed Carpenter MW (2007) Gestational diabetes, pregnancy hypertension, and late vascular disease. Diabetes Care 30(Suppl 2):S246–S250CrossRefPubMed
8.
go back to reference Göbl CS, Bozkurt L, Rivic P et al (2012) A two-step screening algorithm including fasting plasma glucose measurement and a risk estimation model is an accurate strategy for detecting gestational diabetes mellitus. Diabetologia 55:3173–3181CrossRefPubMed Göbl CS, Bozkurt L, Rivic P et al (2012) A two-step screening algorithm including fasting plasma glucose measurement and a risk estimation model is an accurate strategy for detecting gestational diabetes mellitus. Diabetologia 55:3173–3181CrossRefPubMed
9.
go back to reference Allard C, Sahyouni E, Menard J et al (2015) Gestational diabetes mellitus identification based on self-monitoring of blood glucose. Can J Diabetes 39:162–168CrossRefPubMed Allard C, Sahyouni E, Menard J et al (2015) Gestational diabetes mellitus identification based on self-monitoring of blood glucose. Can J Diabetes 39:162–168CrossRefPubMed
10.
go back to reference Bonis C, Lorenzini F, Bertrand M et al (2016) Glucose profiles in pregnant women after a gastric bypass: findings from continuous glucose monitoring. Obes Surg 26:2150–2155CrossRefPubMed Bonis C, Lorenzini F, Bertrand M et al (2016) Glucose profiles in pregnant women after a gastric bypass: findings from continuous glucose monitoring. Obes Surg 26:2150–2155CrossRefPubMed
Metadata
Title
Altered glucose profiles and risk for hypoglycaemia during oral glucose tolerance testing in pregnancies after gastric bypass surgery
Authors
Michael Feichtinger
Tina Stopp
Sandra Hofmann
Stephanie Springer
Sophie Pils
Alexandra Kautzky-Willer
Herbert Kiss
Wolfgang Eppel
Andrea Tura
Latife Bozkurt
Christian S. Göbl
Publication date
01-01-2017
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 1/2017
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-016-4128-8

Other articles of this Issue 1/2017

Diabetologia 1/2017 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.