# Continuous Glucose Monitoring Improves Weight Loss and Hypoglycemic Symptoms in a Non-Diabetic Bariatric Patient 14 Years After RYGB: A Case Report

## TL;DR

A bariatric surgery patient used continuous glucose monitoring to improve weight loss and reduce hypoglycemic symptoms 14 years after surgery.

## Contribution

Demonstrates the potential of CGM in managing glucose variability and symptoms in long-term post-RYGB patients.

## Key findings

- CGM revealed significant glycemic variability with peaks and dips in a post-RYGB patient.
- Dietary adjustments based on CGM data led to improved symptoms and weight loss.
- CGM may support long-term metabolic management in post-bariatric surgery patients.

## Abstract

Background and Clinical Significance: Roux-en-Y gastric bypass (RYGB) significantly alters glucose metabolism, yet managing glucose variability in patients undergoing bariatric surgery remains challenging. Continuous Glucose Monitoring (CGM) offers real-time insights into glucose fluctuations and may support long-term metabolic management in this population. This case highlights the utility of CGM in identifying postprandial glycemic variability and guiding dietary adjustments. Case Presentation: A 45-year-old female, 14 years post-RYGB, presented with symptoms including postprandial fatigue, nocturnal cravings, and unexplained weight gain, despite adherence to nutritional guidelines. Her BMI had decreased from 52 kg/m2 (pre-surgery) to 29 kg/m2. She was provided with a CGM device (FreeStyle Libre 3) by the clinical team and instructed to monitor glucose without modifying her routine initially. Data revealed significant glycemic variability, with peaks up to 220 mg/dL and hypoglycemic dips to 45 mg/dL. Based on this, she adjusted her diet by reducing non-complex carbohydrates and increasing vegetables, proteins, and complex carbohydrates. Within two weeks, her symptoms improved, including better sleep and energy levels, accompanied by a 3 kg weight loss following dietary adjustments informed by CGM feedback. Conclusions: This case suggests how CGM can empower patients having undergone bariatric surgery to manage glucose fluctuations through informed self-management. The patient’s ability to identify and address glucose variability without formal intervention highlights CGM’s potential as a supportive tool in long-term care. While further studies are needed, this case suggests CGM may benefit similar patients experiencing postprandial symptoms or weight regain after bariatric surgery.