Faculty Collaboration Database

Diabetes remission and glycemic response to pre-bariatric surgery diet. J Surg Res 2013 Nov;185(1):1-5

Date

07/13/2013

Pubmed ID

23845864

Pubmed Central ID

PMC6377257

DOI

10.1016/j.jss.2013.06.014

Scopus ID

2-s2.0-84886718411 (requires institutional sign-in at Scopus site)   12 Citations

Abstract

BACKGROUND: Before bariatric surgery, some patients with type 2 diabetes mellitus (T2DM) experience improvement in blood glucose control and reduced insulin requirements while on a preoperative low-calorie diet (LCD). We hypothesized that patients who exhibit a significant glycemic response to this diet are more likely to experience remission of their diabetes in the postoperative period.

MATERIALS AND METHODS: Insulin-dependent T2DM patients undergoing bariatric surgery between August 2006 and February 2011 were eligible for inclusion. Insulin requirements at day 0 and 10 of the LCD were compared. Patients with a ≥ 50% reduction in total insulin dosage to maintain appropriate blood glucose control were considered rapid responders to the preoperative LCD. All others were non-rapid responders. We analyzed T2DM remission rates up to 1 y postoperatively.

RESULTS: A total of 51 patients met inclusion criteria and 29 were categorized as rapid responders (57%). The remaining 22 were considered non-rapid responders (43%). The two groups did not differ demographically. Rapid responders had greater T2DM remission rates at 6 (44% versus 13.6%; P = 0.02) and 12 mo (72.7% versus 5.9%; P < 0.01). In patients undergoing laparoscopic gastric bypass, rapid responders showed greater excess weight loss at 3 mo (40.1% versus 28.2%; P < 0.01), 6 mo (55.2% versus 40.2%; P < 0.01), and 12 mo (67.7% versus 47.3%; P < 0.01).

CONCLUSIONS: Insulin-dependent T2DM bariatric surgery patients who display a rapid glycemic response to the preoperative LCD are more likely to experience early remission of T2DM postoperatively and greater weight loss.

Author List

Biro SM, Olson DL, Garren MJ, Gould JC

Author

Jon Gould MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Bariatric Surgery
Blood Glucose
Caloric Restriction
Diabetes Mellitus, Type 2
Female
Follow-Up Studies
Glycemic Index
Humans
Male
Middle Aged
Obesity, Morbid
Preoperative Period
Remission Induction
Retrospective Studies
Weight Loss