Computational modelling of self-reported dietary carbohydrate intake on glucose concentrations in patients undergoing Roux-en-Y gastric bypass versus one-anastomosis gastric bypass

Show full item record



Permalink

http://hdl.handle.net/10138/337155

Citation

Ashrafi , R A , Ahola , A J , Rosengard-Barlund , M , Saarinen , T , Heinonen , S , Juuti , A , Marttinen , P & Pietiläinen , K H 2021 , ' Computational modelling of self-reported dietary carbohydrate intake on glucose concentrations in patients undergoing Roux-en-Y gastric bypass versus one-anastomosis gastric bypass ' , Annals of Medicine , vol. 53 , no. 1 , pp. 1885-1895 . https://doi.org/10.1080/07853890.2021.1964035

Title: Computational modelling of self-reported dietary carbohydrate intake on glucose concentrations in patients undergoing Roux-en-Y gastric bypass versus one-anastomosis gastric bypass
Author: Ashrafi, Reza A.; Ahola, Aila J.; Rosengard-Barlund, Milla; Saarinen, Tuure; Heinonen, Sini; Juuti, Anne; Marttinen, Pekka; Pietiläinen, Kirsi H.
Contributor organization: CAMM - Research Program for Clinical and Molecular Metabolism
Clinicum
HUS Abdominal Center
Department of Medicine
Nefrologian yksikkö
Endokrinologian yksikkö
University of Helsinki
II kirurgian klinikka
Date: 2021-01-01
Language: eng
Number of pages: 11
Belongs to series: Annals of Medicine
ISSN: 0785-3890
DOI: https://doi.org/10.1080/07853890.2021.1964035
URI: http://hdl.handle.net/10138/337155
Abstract: Objectives Our aim was to investigate in a real-life setting the use of machine learning for modelling the postprandial glucose concentrations in morbidly obese patients undergoing Roux-en-Y gastric bypass (RYGB) or one-anastomosis gastric bypass (OAGB). Methods As part of the prospective randomized open-label trial (RYSA), data from obese (BMI >= 35 kg/m(2)) non-diabetic adult participants were included. Glucose concentrations, measured with FreeStyle Libre, were recorded over 14 preoperative and 14 postoperative days. During these periods, 3-day food intake was self-reported. A machine learning model was applied to estimate glycaemic responses to the reported carbohydrate intakes before and after the bariatric surgeries. Results Altogether, 10 participants underwent RYGB and 7 participants OAGB surgeries. The glucose concentrations and carbohydrate intakes were reduced postoperatively in both groups. The relative time spent in hypoglycaemia increased regardless of the operation (RYGB, from 9.2 to 28.2%; OAGB, from 1.8 to 37.7%). Postoperatively, we observed an increase in the height of the fitted response curve and a reduction in its width, suggesting that the same amount of carbohydrates caused a larger increase in the postprandial glucose response and that the clearance of the meal-derived blood glucose was faster, with no clinically meaningful differences between the surgeries. Conclusions A detailed analysis of the glycaemic responses using food diaries has previously been difficult because of the noisy meal data. The utilized machine learning model resolved this by modelling the uncertainty in meal times. Such an approach is likely also applicable in other applications involving dietary data. A marked reduction in overall glycaemia, increase in postprandial glucose response, and rapid glucose clearance from the circulation immediately after surgery are evident after both RYGB and OAGB. Whether nondiabetic individuals would benefit from monitoring the post-surgery hypoglycaemias and the potential to prevent them by dietary means should be investigated. KEY MESSAGES The use of a novel machine learning model was applicable for combining patient-reported data and time-series data in this clinical study. Marked increase in postprandial glucose concentrations and rapid glucose clearance were observed after both Roux-en-Y gastric bypass and one-anastomosis gastric bypass surgeries. Whether nondiabetic individuals would benefit from monitoring the post-surgery hypoglycaemias and the potential to prevent them by dietary means should be investigated.
Subject: Bayes' theorem
computational modelling
dietary intake
one-anastomosis gastric bypass
post-prandial glucose response
Roux-en-Y gastric bypass
POSTCHALLENGE PLASMA-GLUCOSE
TERM-FOLLOW-UP
SINGLE ANASTOMOSIS
BARIATRIC SURGERY
MEASUREMENT ERROR
GLYCEMIC SPIKES
OBESITY
RISK
HYPOGLYCEMIA
MORTALITY
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


Files in this item

Total number of downloads: Loading...

Files Size Format View
Computational_m ... _gastric_bypass_versus.pdf 2.068Mb PDF View/Open

This item appears in the following Collection(s)

Show full item record