Accuracy of Continuous Glucose Monitoring in Adults With Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass Surgery Under Stable and Dynamic Glucose Conditions
Authors' conclusion
Meal-induced glucose dynamics, particularly rapid declines, challenge CGM accuracy in people with PBH and must be carefully considered when diagnosing or managing the condition.
Study context
- Population
- Adults with postbariatric hypoglycemia (PBH) after RYGB
- Participants
- 70 adults1,822 CGM-BG pairs
- Comparison
- Dexcom G6 CGM vs reference venous blood glucose (BG)
- Outcome
- CGM accuracy during stable and dynamic postmeal glucose periods
Methodological detailsstandardized solid mixed-meal test, venous whole-blood reference sampling
- Standardized solid mixed-meal test
- Venous whole-blood reference sampling
Performance
As reported in the abstract
CGM accuracy
| Test or model | Mean absolute relative difference, stable | Mean absolute relative difference, dynamic | Pairs within 15%/15 mg/dL after meal test | Pairs within 20%/20 mg/dL | Pairs within 30%/30 mg/dL |
|---|---|---|---|---|---|
| Dexcom G6 | 9.6% | 16.4% | 67.6% | 78.0% | 90.8% |
Dexcom G6
Mean absolute relative difference, stable9.6%
Mean absolute relative difference, dynamic16.4%
Pairs within 15%/15 mg/dL after meal test67.6%
Pairs within 20%/20 mg/dL78.0%
Pairs within 30%/30 mg/dL90.8%
- CGM values at plasma glucose nadir systematically higher (bias)
- 8.2 mg/dL
- Plasma-interstitium time delay
- 9.8 min
Further findings
Predictors of CGM accuracy
- No participant or sensor characteristic had a significant impact on CGM accuracy
Original publication
Accuracy of Continuous Glucose Monitoring in Adults With Postbariatric Hypoglycemia After Roux-en-Y Gastric Bypass Surgery Under Stable and Dynamic Glucose Conditions. Diabetes Care. Published 31 March 2026. doi:10.
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