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Surgery Today

22-03-2024 | Malnutrition | Original Article

Impact of hypoglycemia after gastrectomy on Global Leader Initiative on Malnutrition-defined malnutrition: a retrospective study

Authors: Keiji Nishibeppu, Takeshi Kubota, Masayuki Yubakami, Takuma Ohashi, Jun Kiuchi, Hiroki Shimizu, Tomohiro Arita, Yusuke Yamamoto, Hirotaka Konishi, Ryo Morimura, Atsushi Shiozaki, Hisashi Ikoma, Yoshiaki Kuriu, Hitoshi Fujiwara, Eigo Otsuji

Published in: Surgery Today

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Abstract

Purpose

The Global Leader Initiative on Malnutrition (GLIM) criteria were developed in 2018 as a global indicator of malnutrition, and the term ‘malnutrition-sarcopenia syndrome’ was established. Recently, it has been reported that fluctuations in blood glucose are related to sarcopenia. In this study, we investigated the effects of glucose fluctuations on malnutrition after gastrectomy using a continuous glucose monitoring (CGM) device.

Methods

We analyzed the data of 69 patients with gastric cancer (GC) who underwent curative gastrectomy between November 2017 and December 2020. CGM was performed over a 2-week period at 1 month and 1 year after surgery. The GLIM criteria included weight loss, the body mass index (BMI), and the psoas muscle mass index (PMI).

Results

One year after surgery, 25 and 35 patients had severe and moderate malnutrition, respectively. The time below range (TBR) (percent of time the glucose concentration was < 70 mg/dL) and nocturnal (00:00–06:00) TBR were significantly higher in the severe malnutrition group than in the other groups (TBR: normal/moderate 17.9% vs. severe 21.6%, P = 0.039, nocturnal TBR; normal/moderate 30.6% vs. severe 41.1%, P = 0.034).

Conclusions

Post-gastrectomy hypoglycemia, including long nocturnal hypoglycemia, was higher in severely malnourished patients than in other patients even 1 year after surgery. Prevention of nocturnal hypoglycemia may be the key to improving malnutrition following gastrectomy.
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Metadata
Title
Impact of hypoglycemia after gastrectomy on Global Leader Initiative on Malnutrition-defined malnutrition: a retrospective study
Authors
Keiji Nishibeppu
Takeshi Kubota
Masayuki Yubakami
Takuma Ohashi
Jun Kiuchi
Hiroki Shimizu
Tomohiro Arita
Yusuke Yamamoto
Hirotaka Konishi
Ryo Morimura
Atsushi Shiozaki
Hisashi Ikoma
Yoshiaki Kuriu
Hitoshi Fujiwara
Eigo Otsuji
Publication date
22-03-2024
Publisher
Springer Nature Singapore
Published in
Surgery Today
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-024-02799-w