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Reversal of Type 2 diabetes after bariatric surgery is determined by the degree of achieved weight loss in both short- and long-duration diabetes

Lookup NU author(s): Dr Sarah Steven, Dr Peter Carey, Professor Roy Taylor

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Abstract

AimTo define the impact of duration of diabetes and extent of weight loss on the reversibility of Type 2 diabetes after bariatric surgery.MethodsComplete 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 HbA(1c) < 43 mmol/mol (6.1%) were excluded. Diabetes duration was defined as: short, <4 years; medium, 4-8 years; and long, >8 years.ResultsAn HbA(1c) of <43mmol/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 < 25kg. In the whole cohort there was a clear relationship of greater weight loss with lower HbA(1c) levels (R-s = -0.53; P<0.0001).ConclusionsThe 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.What's new? The interaction between duration of diabetes and extent of weight loss in defining diabetes reversal after bariatric surgery has not previously been investigated in a cohort representative of the heterogeneous population undergoing bariatric surgery with a clinically verified diagnosis of Type 2 diabetes. These data have implications for clinical practice, in particular for the selection of patients for bariatric surgery but, more generally, for our understanding of the pathophysiology of Type 2 diabetes.


Publication metadata

Author(s): Steven S, Carey PE, Small PK, Taylor R

Publication type: Article

Publication status: Published

Journal: Diabetic Medicine

Year: 2015

Volume: 32

Issue: 1

Pages: 47-53

Print publication date: 01/01/2015

Online publication date: 12/09/2014

Acceptance date: 16/08/2014

ISSN (print): 0742-3071

ISSN (electronic): 1464-5491

Publisher: Wiley-Blackwell

URL: http://dx.doi.org/10.1111/dme.12567

DOI: 10.1111/dme.12567


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