1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
3Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea
Copyright © 2022 Korean Diabetes Association
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
Sung Hee Choi has been editorial board member of the Diabetes & Metabolism Journal since 2021. She was not involved in the review process of this article. Otherwise, there was no conflict of interest.
AUTHOR CONTRIBUTIONS
Conception or design: K.K., Y.S.P., T.J.O.
Acquisition, analysis, or interpretation of data: K.K., S.H.C., H.C.J., Y.S.P., T.J.O.
Drafting the work or revising: K.K., Y.S.P., T.J.O.
Final approval of the manuscript: K.K., S.H.C., H.C.J., Y.S.P., T.J.O.
FUNDING
None
Values are presented as mean±standard deviation or number (%).
BMI, body mass index; BP, blood pressure; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate; LSG/DJB, laparoscopic sleeve gastrectomy with duodenojejunal bypass; RYGB, Roux-en-Y gastric bypass; LBPD, laparoscopic biliopancreatic diversion.
Before surgery | After surgery | Mean difference (95% CI) | P value | |
---|---|---|---|---|
Time CGM active, % | 90.4±13.3 | 79.8±19.7 | 10.59 (0.8 to 20.4) | 0.033 |
Mean glucose, mg/dL | 147.0±40.4 | 95.5±17.1 | 51.6 (33.9 to 69.2) | <0.001 |
Mean glucose during daytimea, mg/dL | 149.8±39.4 | 95.9±17.4 | 53.9 (38.0 to 69.8) | <0.001 |
Mean glucose during nighttimeb, mg/dL | 138.0±64.5 | 91.1±20.0 | 46.9 (13.0 to 80.8) | 0.002 |
CV, % | 29.2±9.9 | 20.1±9.0 | 9.1 (3.2 to 14.9) | 0.005 |
CV during daytimea, % | 28.3±9.6 | 19.6±8.8 | 8.7 (2.7 to 14.7) | 0.012 |
CV during nighttimeb, % | 21.2±11.3 | 17.1±11.3 | 4.2 (−4.9 to 13.2) | 0.184 |
TAR >250 mg/dL, % | 6.8±12.4 | 0.0±0.0 | 6.8 (1.0 to 12.6) | 0.005 |
TAR >180 mg/dL, % | 23.9±25.3 | 1.1±5.0 | 22.8 (10.8 to 34.7) | <0.001 |
TIR 70−180 mg/dL, % | 73.1±24.2 | 82.8±24.5 | −9.7 (−26.7 to 7.3) | 0.247 |
TBR <70 mg/dL, % | 3.0±5.7 | 16.1±23.9 | −13.1 (−23.5 to −2.7) | 0.019 |
TBR <70 mg/dL during daytimea, % | 2.3±4.9 | 13.7±23.0 | −11.4 (−21.1 to −1.7) | 0.021 |
TBR <70 mg/dL during nighttimeb, % | 4.1±8.4 | 17.3±27.5 | −13.2 (−26.8 to 0.4) | 0.068 |
TBR <54 mg/dL, % | 0.4±0.9 | 5.4±10.7 | −5.0 (−9.8 to −0.2) | 0.035 |
TBR <54 mg/dL during daytimea, % | 0.4±1.1 | 3.9±8.1 | −3.5 (−7.1 to 0.1) | 0.050 |
TBR <54 mg/dL during nighttimeb, % | 0.1±0.5 | 10.2±21.0 | −10.1 (−20.2 to 0.0) | 0.043 |
Before surgery | After surgery | Mean difference (95% CI) | P value | |
---|---|---|---|---|
FPG, mg/dL | 164.1±64.6 | 113.1±21.7 | 51.0 (19.0 to 82.9) | 0.001 |
Insulin, μIU/mLa | 16.4±12.9 | 10.2±2.8 | 6.2 (−0.2 to 12.6) | 0.016 |
C-peptide, ng/mLa | 3.9±2.3 | 2.3±1.3 | 1.6 (0.7 to 2.5) | 0.001 |
FFA, μEq/Lb | 470.3±195.8 | 689.4±225.9 | −219.1 (−343.5 to −94.7) | 0.008 |
HOMA-IRa | 6.6±4.9 | 2.8±1.2 | 3.8 (1.3 to 6.3) | 0.003 |
HOMA-Ba | 81.8±74.3 | 111.2±96.1 | −29.4 (−103.4 to 44.6) | 0.173 |
Adipo-IRc | 61.4±61.9 | 53.8±30.5 | 7.6 (−19.4 to 34.5) | 0.959 |
Values are presented as mean±standard deviation.
CI, confidence interval; FPG, fasting plasma glucose; FFA, free fatty acid; HOMA-IR, homeostatic model assessment for insulin resistance; HOMA-B, homeostatic model assessment for beta cell function; Adipo-IR, adipose tissue insulin resistance.
a n=15,
b n=11,
c n=10.
Variable | Value |
---|---|
No. of male/female | 5/15 |
| |
Age, yr | 47.2±9.1 |
| |
Body weight, kg | 99.8±17.2 |
| |
BMI, kg/m2 | 37.2±5.7 |
| |
Systolic BP, mm Hg | 134.0±11.3 |
| |
Diastolic BP, mm Hg | 79.0±9.5 |
| |
Diabetes duration, yr | 5.6±7.0 |
| |
FPG, mg/dL | 164.1±64.6 |
| |
HbA1c, % | 8.1±1.8 |
| |
Cholesterol, mg/dL | 162.0±37.1 |
| |
Triglyceride, mg/dL | 148.4±52.6 |
| |
HDL-C, mg/dL | 50.4±11.7 |
| |
LDL-C, mg/dL | 97.5±28.1 |
| |
eGFR, mL/min/1.73 m2 | 98.2±29.3 |
| |
Hypertension | 17 (85.0) |
| |
Dyslipidemia | 17 (85.0) |
| |
Insulin therapy | 9 (45.0) |
| |
Metabolic surgery type | |
LSG/DJB | 10 (50.0) |
LSG | 6 (30.0) |
RYGB | 3 (15.0) |
LBPD | 1 (5.0) |
Before surgery | After surgery | Mean difference (95% CI) | P value | |
---|---|---|---|---|
Time CGM active, % | 90.4±13.3 | 79.8±19.7 | 10.59 (0.8 to 20.4) | 0.033 |
Mean glucose, mg/dL | 147.0±40.4 | 95.5±17.1 | 51.6 (33.9 to 69.2) | <0.001 |
Mean glucose during daytime |
149.8±39.4 | 95.9±17.4 | 53.9 (38.0 to 69.8) | <0.001 |
Mean glucose during nighttime |
138.0±64.5 | 91.1±20.0 | 46.9 (13.0 to 80.8) | 0.002 |
CV, % | 29.2±9.9 | 20.1±9.0 | 9.1 (3.2 to 14.9) | 0.005 |
CV during daytime |
28.3±9.6 | 19.6±8.8 | 8.7 (2.7 to 14.7) | 0.012 |
CV during nighttime |
21.2±11.3 | 17.1±11.3 | 4.2 (−4.9 to 13.2) | 0.184 |
TAR >250 mg/dL, % | 6.8±12.4 | 0.0±0.0 | 6.8 (1.0 to 12.6) | 0.005 |
TAR >180 mg/dL, % | 23.9±25.3 | 1.1±5.0 | 22.8 (10.8 to 34.7) | <0.001 |
TIR 70−180 mg/dL, % | 73.1±24.2 | 82.8±24.5 | −9.7 (−26.7 to 7.3) | 0.247 |
TBR <70 mg/dL, % | 3.0±5.7 | 16.1±23.9 | −13.1 (−23.5 to −2.7) | 0.019 |
TBR <70 mg/dL during daytime |
2.3±4.9 | 13.7±23.0 | −11.4 (−21.1 to −1.7) | 0.021 |
TBR <70 mg/dL during nighttime |
4.1±8.4 | 17.3±27.5 | −13.2 (−26.8 to 0.4) | 0.068 |
TBR <54 mg/dL, % | 0.4±0.9 | 5.4±10.7 | −5.0 (−9.8 to −0.2) | 0.035 |
TBR <54 mg/dL during daytime |
0.4±1.1 | 3.9±8.1 | −3.5 (−7.1 to 0.1) | 0.050 |
TBR <54 mg/dL during nighttime |
0.1±0.5 | 10.2±21.0 | −10.1 (−20.2 to 0.0) | 0.043 |
Before surgery | After surgery | Mean difference (95% CI) | P value | |
---|---|---|---|---|
FPG, mg/dL | 164.1±64.6 | 113.1±21.7 | 51.0 (19.0 to 82.9) | 0.001 |
Insulin, μIU/mL |
16.4±12.9 | 10.2±2.8 | 6.2 (−0.2 to 12.6) | 0.016 |
C-peptide, ng/mL |
3.9±2.3 | 2.3±1.3 | 1.6 (0.7 to 2.5) | 0.001 |
FFA, μEq/L |
470.3±195.8 | 689.4±225.9 | −219.1 (−343.5 to −94.7) | 0.008 |
HOMA-IR |
6.6±4.9 | 2.8±1.2 | 3.8 (1.3 to 6.3) | 0.003 |
HOMA-B |
81.8±74.3 | 111.2±96.1 | −29.4 (−103.4 to 44.6) | 0.173 |
Adipo-IR |
61.4±61.9 | 53.8±30.5 | 7.6 (−19.4 to 34.5) | 0.959 |
Values are presented as mean±standard deviation or number (%). BMI, body mass index; BP, blood pressure; FPG, fasting plasma glucose; HbA1c, glycosylated hemoglobin; HDL-C, high-density lipoprotein cholesterol; LDL-C, low-density lipoprotein cholesterol; eGFR, estimated glomerular filtration rate; LSG/DJB, laparoscopic sleeve gastrectomy with duodenojejunal bypass; RYGB, Roux-en-Y gastric bypass; LBPD, laparoscopic biliopancreatic diversion.
Values are presented as mean±standard deviation. CI, confidence interval; CGM, continuous glucose monitoring; CV, coefficient of variation; TAR, time above range; TIR, time in range; TBR, time below range. From 6:00 AM to midnight, From midnight to 6:00 AM.
Values are presented as mean±standard deviation. CI, confidence interval; FPG, fasting plasma glucose; FFA, free fatty acid; HOMA-IR, homeostatic model assessment for insulin resistance; HOMA-B, homeostatic model assessment for beta cell function; Adipo-IR, adipose tissue insulin resistance.