PP127 - MATERNAL NUTRITIONAL STATUS AND GLUCOSE METABOLISM AFTER BARIATRIC SURGERY

PP127

MATERNAL NUTRITIONAL STATUS AND GLUCOSE METABOLISM AFTER BARIATRIC SURGERY

W. Neibig^1,2,*, J. Nowak^1,2, A. Mayadali¹, M. Hildebrand¹, S. Wollersheim¹, P. Wagenlecher³, U. Heger⁴, J. Szendroedi^1,2,5, A. Sulaj^1,2

¹Department of Endocrinology, Diabetology, Metabolic Diseases, and Clinical Chemistry (Internal Medicine 1), Heidelberg University Hospital, Heidelberg, ²German Center for Diabetes Research (DZD), Neuherberg, ³Department of General Internal Medicine and Psychosomatics, ⁴Department of General, Visceral, and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, ⁵Joint Heidelberg-IDC Translational Diabetes Program, Helmholtz Zentrum Munich, Neuherberg, Germany

Rationale: Pregnancy within two years after bariatric surgery (BS) is discouraged due to rapid weight loss.We analysed nutrient status and glucose metabolism during pregnancy after BS in a prospective study.

Methods: Data after gastric sleeve and/or Roux-en Y gastric bypass from 38 women (age 29.8 [21.4; 35.5] years), for 68 pregnancies were analysed in three groups based on surgery-to-conception interval (BSCI): early (≤12 months, n=7), middle (12-24 months, n=11), and late (>24 months, n=14). Nutritional status was assessed through albumin, vitamin A, E, D, B12, folic acid, selenium, zinc, ferritin, transferrin, calcium, and magnesium. Gestational diabetes (GDM) was screened in 53 singleton pregnancies using glucose profiles (GP) or oral glucose tolerance test (oGTT).

Results: Weight loss until the first pregnancy was 30% (conception BMI 35.7 [30.7;45.3] kg/m²). Nutrient deficiencies were common: Vitamin D (86 %, 3rd trimester), ferritin and magnesium (both 73 %, 2nd trimester), zinc (57 %, 2nd trimester), vitamin B12, and selenium (both 20 %, 3rd trimester), and similar among the subgroups. 74% of pregnancies were screened for GDM (67% with GP, 56% with oGTT, 23% with both), 11 % were not screened and in 15% information was missing. 35 % of the screened pregnancies had an abnormal GP (2 and 7 from the middle and the late BSCI) and 32 % had an abnormal oGTT (1 each from the early and middle, 5 from the late BSCI). 8 women were diagnosed with GDM in the first pregnancy (1 from the early and middle BSCI each, 6 from the late BSCI), 4 requiring insulin therapy. 5 women had a previously diagnosed diabetes (all from the late BSCI), with 40% of them reaching diabetes remission after BS.

Conclusion: Pregnant women after BS experience frequently nutrient deficiencies and an increased risk for GDM despite specialized care. Specialized nutritional and diabetes care in pregnancies after BS is essential.

Disclosure of Interest: None declared