Increased glycemic variability in pregnant women with Roux-en-Y gastric bypass compared with sleeve gastrectomy

Author:

Alexiadou Kleopatra,Ansari Saleem,Jones Bryony,Yu Christina,Dornhorst Anne,Oliver Nick,Tsironis Christos,Purkayastha Sanjay,Ahmed Ahmed,Agha-Jaffar Rochan,Khoo BernardORCID,Tan Tricia M-MORCID

Abstract

IntroductionBariatric surgery is associated with adverse pregnancy outcomes such as reduced birth weight and premature birth. One possible mechanism for this is increased glycemic variability (GV) which occurs after bariatric surgery. The objective of this study was to compare the effect of Roux-en-Y gastric bypass (RYGB) versus vertical sleeve gastrectomy (SG) on GV during pregnancy and to investigate the relationships of GV, type of bariatric surgery and maternal and neonatal outcomes.Research design and methodsFourteen pregnant women after RYGB and 14 after SG were investigated with continuous glucose monitoring in their second or third trimester in this observational study carried out as part of routine clinical care.ResultsPregnant women with RYGB had similar mean interstitial glucose values but significantly increased indices of GV and a lower %time in range 3.9–7.8 mmol/L (70–140 mg/dL), compared with SG.ConclusionsPregnant women who have undergone RYGB have greater GV during pregnancy compared with those who have undergone SG. Further research is needed to establish the relationship between GV and pregnancy outcomes to determine the preferred bariatric operation in women of reproductive age, and whether interventions to reduce GV might improve outcomes.

Publisher

BMJ

Subject

Endocrinology, Diabetes and Metabolism

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