Postprandial Asymptomatic Glycemic Fluctuations after Gastrectomy for Gastric Cancer Using Continuous Glucose Monitoring Device

Motonari Ri; Souya Nunobe; Satoshi Ida; Naoki Ishizuka; Shinichiro Atsumi; Masaru Hayami; Rie Makuuchi; Koshi Kumagai; Manabu Ohashi; Takeshi Sano

doi:10.5230/jgc.2021.21.e31

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저자정보: Motonari Ri (Cancer Institute Hospital Japanese Foundation for Cancer Research) Souya Nunobe (Cancer Institute Hospital Japanese Foundation for Cancer Research) Satoshi Ida (Cancer Institute Hospital Japanese Foundation for Cancer Research) Naoki Ishizuka (Cancer Institute Hospital Japanese Foundation for Cancer Research) Shinichiro Atsumi (Cancer Institute Hospital Japanese Foundation for Cancer Research) Masaru Hayami (Cancer Institute Hospital Japanese Foundation for Cancer Research) Rie Makuuchi (Cancer Institute Hospital Japanese Foundation for Cancer Research) Koshi Kumagai (Cancer Institute Hospital Japanese Foundation for Cancer Research) Manabu Ohashi (Cancer Institute Hospital Japanese Foundation for Cancer Research) Takeshi Sano (Cancer Institute Hospital Japanese Foundation for Cancer Research)

저널정보: 대한위암학회 Journal of Gastric Cancer Journal of Gastric Cancer 제21권 제4호

발행연도: 2021.12

수록면: 325 - 334 (10page)

DOI: 10.5230/jgc.2021.21.e31

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Purpose: Although dumping symptoms are thought to involve postprandial glycemic changes, postprandial glycemic variability without dumping symptoms remains poorly understood due to the lack of a method that allows the easy and continuous measurement of blood glucose levels. Materials and Methods: Patients having undergone distal gastrectomy with Billroth-I (DG-BI) or Roux-en-Y reconstruction (DG-RY), total gastrectomy with RY (TG-RY) and pylorus preserving gastrectomy (PPG) for gastric cancer 3 months to 3 years prior, diagnosed as pathological stage I or II, were prospectively enrolled from March 2018 to January 2020. The interstitial tissue glycemic levels were measured every 15 min, up to 14 days by continuous glucose monitoring. Moreover, using a diary recording the diet and symptoms, asymptomatic glucose profiles without sugar supplementation within 3 h postprandially were compared among the four procedures. Results: A total of 40 patients were enrolled, 10 patients for each of the four procedures. There were 47 glucose profiles with DG-BI, 46 profiles with DG-RY, 38 profiles with TG-RY, and 46 profiles with PPG. PPG showed the slowest increase with a subsequent gradual decrease in glucose fluctuations, without hyperglycemia or hypoglycemia, among the four procedures. In contrast, TG-RY and DG-RY showed spike-like glycemic variability, sharp rises during meals, and rapid drops. The glucose profiles of DG-BI were milder than those of RY. Conclusions: The asymptomatic glycemic changes after meals differ among the types of surgical procedures for gastric cancer. Given the mild glycemic fluctuations in PPG and the glucose spikes in TG-RY and DG-RY, pylorus preservation and physiological reconstruction without changes in food pathways may optimize postprandial glucose profiles after gastrectomy.

#Gastric cancer #Gastrectomy #Blood glucose #Hyperglycemia #Hypoglycemia

참고문헌 (38)

참고문헌 신청

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