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Continuous glucose monitoring assessment in patients suffering from anorexia nervosa reveals chronic prolonged mild hypoglycemia all over the nycthemeron
Ist Teil von
European eating disorders review, 2023-05, Vol.31 (3), p.402-412
Ort / Verlag
England: John Wiley and Sons, Limited
Erscheinungsjahr
2023
Quelle
Wiley Online Library Journals Frontfile Complete
Beschreibungen/Notizen
Objective
Anorexia nervosa (AN) is an eating disorder characterised by voluntary dietary restriction leading to severe undernutrition. Hypoglycaemia is mostly described through severe case reports and is always evaluated by fasting or post‐meal blood glucose, showing nothing about hypoglycaemia's length or duration. The interest of continuous interstitial glucose monitoring (CGM), largely used in diabetes mellitus, has never been evaluated in AN patients.
Method
Glycaemia cycles in AN patients were assessed using CGM over 5 days and then analysed according to food intake.
Results
Mean glycaemia was within normal range. 91% of the patients presented with at least one episode with glycaemia under 70 mg/dl. Within the 24 h, the percentage of time spent with a glycaemia under 70 mg/dl was of 20.82 ± 3.90% with a maximum of 52%. We found 2.52 ± 0.33 hypoglycaemia events per 24 h, including 21.11 ± 3.76% at night. CGM parameters correlated with cortisol and IGF1 plasma levels. Comparison with estimated carbohydrate intakes discriminated concordant and non‐concordant estimations depending on patient.
Conclusions
AN patients display chronic prolonged mild hypoglycaemia all over the nycthemeron despite normal fasting glycaemia. Associated adaptive increased counter‐regulatory hormones might protect AN patients from deeper hypoglycaemia. CGM allowed testing food intake self‐estimation reliability of AN patients and could be a very useful biofeedback tool.
Highlights
Anorexia nervosa (AN) patients display chronic prolonged mild hypoglycaemia all over the 24 h.
chronic prolonged mild hypoglycaemia in AN patients is associated with adaptive higher counter‐regulatory hormones that might protect them from deeper hypoglycaemia.
Data from Continuous Glucose Monitoring confronted with food intake self‐estimation may become a reliable biofeedback tool during nutrition therapy.