Continuous glucose monitoring assessment in patients suffering from anorexia nervosa reveals chronic prolonged mild hypoglycemia all over the nycthemeron. (21st December 2022)

• Record Type: Journal Article
• Authors: Germain, Natacha; Genteuil, Clara Devin; Belleton, Gwenaëlle; Da Silva, Trecy Lopes; Exbrayat, Chloé; Degas, Fabien; Hammour, Amira; Gay, Aurélia; Ravey, Baptiste; Massoubre, Catherine; Galusca, Bogdan
• Is Part Of: European eating disorders review. Volume 31:Number 3(2023)
• Page Start: 402
• Page End: 412
• Publication Date: 2022-12-21
• Subjects: anorexia nervosa -- biofeedback -- continuous glucose monitoring -- hypoglycaemia; Eating disorders -- Periodicals; 616.8526
• DOI: 10.1002/erv.2963
• Languages: English
• ISSNs: 1072-4133

Abstract

Abstract: 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.