title: Impact of Carbohydrate Content and Glycemic Load on Postprandial Glucose After Roux-en-Y Gastric Bypass.
abstract: Abnormal glucose profiles have been described after Roux-en-Y gastric bypass (RYGB) with intense postprandial hyperglycemic peaks in some but not all the patients. The underlying mechanisms of these anomalies are not totally understood.
  
  
  
  The aim of this study is to determine whether or not the composition of the meal impacts the existence and maximum interstitial glucose (IG) concentration, measured under real-life conditions.
  
  
  
  Retrospective cohort.
  
  
  
  Referral bariatric surgery left.
  
  
  
  Continuous glucose monitoring (CGM) and meal composition were recorded for at least 3 days on an outpatient basis in 56 patients after RYGB. The presence of postprandial peaks defined by IG above 140 mg/dl, the maximum postprandial IG, the carbohydrate content, and the glycemic load of the meals were analyzed.
  
  
  
  Thirty-two patients had a hyperglycemic peak (PEAK), and 24 did not (NO PEAK). The average max IG was 159.6 ± 33.0 mg/dl in PEAK individuals and 111.8 ± 13.0 mg/dl in NO PEAK. Age was significantly higher in PEAK, but no other parameter was different between the two groups, including meal composition. In the PEAK patients, in multivariate analyses, carbohydrate content in model one and glucose load in model two explained respectively 50 and 26 % of maximum IG variance. For each gram of ingested carbohydrates, interstitial glucose increased by 1.68 mg/dl.
  
  
  
  Following a gastric bypass, under real-life conditions, irrespective of the carbohydrate content of the meal, some patients develop postprandial hyperglycemic peaks, whereas others do not. In patients with postprandial hyperglycemic peaks, the maximum IG depends on the carbohydrate content of the meal.
authors.affiliation: Department of Diabetology, Metabolic Diseases, and Nutrition, CHU Toulouse, Toulouse, France.
authors.forename: Blandine
authors.initials: B
authors.lastname: Tramunt
authors.affiliation: Department of Diabetology, Metabolic Diseases, and Nutrition, CHU Toulouse, Toulouse, France. vaurscharlotte@yahoo.fr.|Department of Diabetology, Metabolic Diseases, and Nutrition, Hôpital Rangueil - TSA 50032, 31059, Toulouse cedex 9, France. vaurscharlotte@yahoo.fr.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Vaurs
authors.affiliation: Department of Diabetology, Metabolic Diseases, and Nutrition, CHU Toulouse, Toulouse, France.
authors.forename: Jocelyne
authors.initials: J
authors.lastname: Lijeron
authors.affiliation: Department of Diabetology, Metabolic Diseases, and Nutrition, CHU Toulouse, Toulouse, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Guillaume
authors.affiliation: Nutrition Unit, Cardiovascular and Metabolism Division, Larrey Hospital, CHU of Toulouse, Toulouse, France.|Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-University of Toulouse 3, CHU de Toulouse, Toulouse, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Ritz
authors.affiliation: Department of Epidemiology, Health Economics and Public Health, UMR1027 INSERM-University of Toulouse 3, CHU de Toulouse, Toulouse, France.
authors.forename: Chloé
authors.initials: C
authors.lastname: Diméglio
authors.affiliation: Department of Diabetology, Metabolic Diseases, and Nutrition, CHU Toulouse, Toulouse, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Hanaire
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis*; D004040:Dietary Carbohydrates; D005260:Female; D015390:Gastric Bypass; D000067940:Glycemic Load; D006801:Humans; D008297:Male; D062407:Meals; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood* / Q000601:surgery*; D019518:Postprandial Period; D012189:Retrospective Studies
chemical_list: D001786:Blood Glucose; D004040:Dietary Carbohydrates
keywords: Bariatric surgery; Carbohydrate content; Continuous glucose monitoring; Gastric bypass; Glycemic load