CGM-Based Glycemic Metrics Support Estimating Nutritional Risk After Total Pancreatectomy: An Exploratory...

Area of Science:

• Endocrinology
• Metabolic Disorders
• Surgical Outcomes

Background:

• Total pancreatectomy leads to pancreatogenic diabetes, causing glycemic variability and malnutrition risk.
• Malnutrition can occur despite adequate intake and pancreatic enzyme replacement therapy (PERT).

Purpose of the Study:

• To investigate the association between glycemic variability and nutritional decline after total pancreatectomy.
• To determine if continuous glucose monitoring (CGM) metrics can predict malnutrition risk.

Main Methods:

• Retrospective analysis of 14 patients post-total pancreatectomy using CGM.
• Nutritional status assessed via Geriatric Nutritional Risk Index (GNRI).
• Comparison of glycemic indices, dietary intake, and PERT between malnutrition-risk progression and nutrition-maintaining groups.

Main Results:

• The malnutrition-risk progression group had higher mean glucose and time above range, and lower time in range (TIR).
• Lower TIR was inversely associated with malnutrition-risk progression, independent of dietary intake or PERT.
• Hyperglycemia and reduced TIR correlated with worsening GNRI.

Conclusions:

• Reduced TIR and hyperglycemia are linked to worsening nutritional status after total pancreatectomy.
• CGM-derived glycemic metrics can identify patients at risk of malnutrition.
• These findings may guide postoperative management strategies.