Evaluation of postprandial hypoglycemia in patients with nonalcoholic fatty liver disease by oral glucose tolerance testing and continuous glucose monitoring

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ObjectiveNonalcoholic fatty liver disease (NAFLD) is often associated with insulin resistance and glucose intolerance. Postprandial hypoglycemia frequently occurs in NAFLD patients; however, the details remain unclear.Patients and methodsThe 75-g oral glucose tolerance test (75gOGTT) in 502 patients with biopsy-proven NAFLD and continuous glucose monitoring (CGM) in 20 patients were performed, and the characteristics and causes of postprandial hypoglycemia were investigated.ResultsThe proportion of patients in the Hypo subgroup [plasma glucose (PG) at 180 minConclusionPostprandial hypoglycemia was identified in many NAFLD patients detected by 75gOGTT and CGM. It was clarified that important causes of postprandial hypoglycemia were related to low HbA1c, an early elevation of PG, low fasting and relatively low early insulin secretion, and delayed hyperinsulinemia.

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