Key result
Bariatric surgery resulted in HbA1c < 43 mmol/mol in 62% of patients with short-duration diabetes versus 26% with long-duration diabetes, with weight loss correlating with lower HbA1c (P<0.0001).
Why the study?
Does the degree of weight loss determine the reversal of Type 2 diabetes after bariatric surgery in patients with varying durations of diabetes?
Cohort (n=89)
No
Does the degree of weight loss determine the reversal of Type 2 diabetes after bariatric surgery in patients with varying durations of diabetes?
Absolute Event Rate: 62% vs 26%
The degree of weight loss is the major determinant of returning to normoglycaemia after bariatric surgery, though patients with longer-duration diabetes require greater weight loss to achieve this.
Supports weight loss as key to post-bariatric normoglycemia in observational data; leaves open whether greater loss overcomes long-duration effects.
AIM: To define the impact of duration of diabetes and extent of weight loss on the reversibility of Type 2 diabetes after bariatric surgery. METHODS: Complete data were collated from 89 individuals with Type 2 diabetes mellitus undergoing any bariatric surgical procedure in a specialist bariatric centre. People with a preoperative HbA1c < 43 mmol/mol (6.1%) were excluded. Diabetes duration was defined as: short, < 4 years; medium, 4-8 years; and long, > 8 years. RESULTS: An HbA1c of <43 mmol/mol (6.1%) was achieved by 62% of patients in the short-duration group and 26% of patients in the long-duration group. Normoglycaemia was rarely achieved in the long-duration group if weight loss was < 25 kg. In the whole cohort there was a clear relationship of greater weight loss with lower HbA1c levels (Rs = -0.53; P < 0.0001). CONCLUSIONS: The study shows that the degree of achieved weight loss is the major determinant of return to normal blood glucose levels after bariatric surgery. Normoglycaemia can be achieved in long-duration Type 2 diabetes, but a greater degree of weight loss is required than for short-duration diabetes.
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Steven et al. (2014) conducted a cohort in Type 2 diabetes mellitus (n=89). Bariatric surgery in short-duration diabetes (< 4 years) vs. Bariatric surgery in long-duration diabetes (> 8 years) was evaluated on Achievement of HbA1c < 43 mmol/mol (6.1%). Bariatric surgery resulted in HbA1c < 43 mmol/mol in 62% of patients with short-duration diabetes versus 26% with long-duration diabetes, with weight loss correlating with lower HbA1c (P<0.0001).
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