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Preoperative Beta Cell Function Is Predictive of Diabetes Remission After Bariatric Surgery

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Abstract

Background

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.

Materials and Methods

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.

Results

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).

Conclusions

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.

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Acknowledgments

We would like to thank Sofia Souteiro, Industrial Engineering and Management student, and Luis Silva, Software Engineer, for their help with the ISEC program.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal

    Pedro Souteiro, Sandra Belo, João Sérgio Neves, Daniela Magalhães, Rita Bettencourt Silva, Sofia Castro Oliveira, Maria Manuel Costa, Ana Saavedra, Joana Oliveira, Filipe Cunha, Eva Lau, César Esteves, Paula Freitas, Ana Varela, Joana Queirós & Davide Carvalho

  2. Faculty of Medicine of University of Porto, Porto, Portugal

    Sandra Belo, Daniela Magalhães, Rita Bettencourt Silva, Sofia Castro Oliveira, Maria Manuel Costa, Ana Saavedra, Joana Oliveira, Filipe Cunha, Eva Lau, César Esteves, Paula Freitas, Ana Varela & Davide Carvalho

  3. Institute for Research and Innovation in Health, University of Porto, Porto, Portugal

    Sandra Belo, Daniela Magalhães, Rita Bettencourt Silva, Sofia Castro Oliveira, Maria Manuel Costa, Ana Saavedra, Joana Oliveira, Filipe Cunha, Eva Lau, César Esteves, Paula Freitas, Ana Varela & Davide Carvalho

  4. Multidisciplinary Group for Surgical Management of Obesity, Centro Hospitalar São João, Porto, Portugal

    Paula Freitas, Ana Varela & Joana Queirós

Authors
  1. Pedro Souteiro
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  2. Sandra Belo
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  3. João Sérgio Neves
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  7. Maria Manuel Costa
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  8. Ana Saavedra
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  9. Joana Oliveira
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  13. Paula Freitas
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  16. Davide Carvalho
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Corresponding author

Correspondence to Pedro Souteiro.

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The authors declare that they have no conflicts of interest.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For this type of study formal consent is not required.

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Souteiro, P., Belo, S., Neves, J.S. et al. Preoperative Beta Cell Function Is Predictive of Diabetes Remission After Bariatric Surgery. OBES SURG 27, 288–294 (2017). https://doi.org/10.1007/s11695-016-2300-3

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  • DOI: https://doi.org/10.1007/s11695-016-2300-3

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