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Preoperative Beta Cell Function Is Predictive of Diabetes Remission After Bariatric Surgery
- Source :
- Obesity Surgery. 27:288-294
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Bariatric surgery can improve glucose metabolism in obese patients with diabetes, but the factors that can predict diabetes remission are still under discussion. The present study aims to examine the impact of preoperative beta cell function on diabetes remission following surgery.We investigated a cohort of 363 obese diabetic patients who underwent bariatric surgery. The impact of several preoperative beta cell function indexes on diabetes remission was explored through bivariate logistic regression models.Postoperative diabetes remission was achieved in 39.9 % of patients. Younger patients (p 0.001) and those with lower HbA1c (p = 0.001) at the baseline evaluation had higher odds of diabetes remission. Use of oral anti-diabetics and insulin therapy did not reach statistical significance when they were adjusted for age and HbA1c. Among the evaluated indexes of beta cell function, higher values of insulinogenix index, Stumvoll first- and second-phase indexes, fasting C-peptide, C-peptide area under the curve (AUC), C-peptide/glucose AUC, ISR (insulin secretion rate) AUC, and ISR/glucose AUC predicted diabetes remission even after adjustment for age and HbA1c. Among them, C-peptide AUC had the higher discriminative power (AUC 0.76; p 0.001).Patients' age and preoperative HbA1c can forecast diabetes remission following surgery. Unlike other studies, our group found that the use of oral anti-diabetics and insulin therapy were not independent predictors of postoperative diabetes status. Preoperative beta cell function, mainly C-peptide AUC, is useful in predicting diabetes remission, and it should be assessed in all obese diabetic patients before bariatric or metabolic surgery.
- Subjects :
- Adult
Blood Glucose
Male
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Bariatric Surgery
Beta-cell Function
030209 endocrinology & metabolism
Carbohydrate metabolism
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Insulin-Secreting Cells
Diabetes mellitus
Weight Loss
medicine
Humans
Insulin
Obesity
Postoperative Period
030212 general & internal medicine
Retrospective Studies
Glycated Hemoglobin
Nutrition and Dietetics
C-Peptide
business.industry
C-peptide
Remission Induction
fungi
Metabolic surgery
food and beverages
Middle Aged
medicine.disease
Surgery
Cross-Sectional Studies
Diabetes Mellitus, Type 2
chemistry
Preoperative Period
Female
business
Subjects
Details
- ISSN :
- 17080428 and 09608923
- Volume :
- 27
- Database :
- OpenAIRE
- Journal :
- Obesity Surgery
- Accession number :
- edsair.doi.dedup.....311ac8cb4049ca890a35488e23218084