Abstract
Although the marked and durable effects of bariatric surgery on early type 2 diabetes is known, there are limited data on the impact of surgery in patients with reduced beta-cell function/reserve. Clinical outcomes of 15 morbidly obese patients with poorly controlled diabetes who underwent bariatric surgery in a 10-year period and had a baseline fasting serum c-peptide ≤0.5 ng/mL were assessed. All patients had glycated hemoglobin >7 % and were on insulin before surgery. Surgical procedures included laparoscopic gastric bypass (n = 9), sleeve (n = 5), and banding (n = 1) without any intraoperative complications. At a mean follow-up of 39.6 ± 22.9 months, a mean reduction in body mass index of 25.1 ± 9.2 % and a mean percent excess weight loss of 61.5 ± 19.7 % were associated with a significant improvement in daily insulin requirement and lipid profile. At the last follow-up point, three patients (20 %) were off insulin, five patients (33.3 %) had a glycated hemoglobin ≤7 %, and one patient (6.7 %) had remission of diabetes. Hypertension resolved or improved in 5 of 11 (45.5 %) hypertensive patients. In conclusion, bariatric surgery can result in improvement of glycemic status and comorbid conditions of obese diabetic patients with diminished beta-cell reserve and may facilitate medical management of diabetes.
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Acknowledgments
This research was supported in part by National Institutes of Health Grant RO1 DK089547 (PRS, JPK, SRK).
Conflict of interest
Ali Aminian, Stacy A. Brethauer, Christopher R. Daigle, John P. Kirwan, Bartolome Burguera, Sangeeta R. Kashyap, and Philip R. Schauer declare that they have no conflict of interest.
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This retrospective article does not contain any studies with human or animal subjects performed by the any of the authors.
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Aminian, A., Brethauer, S.A., Daigle, C.R. et al. Outcomes of bariatric surgery in type 2 diabetic patients with diminished pancreatic secretory reserve. Acta Diabetol 51, 1077–1079 (2014). https://doi.org/10.1007/s00592-014-0642-7
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DOI: https://doi.org/10.1007/s00592-014-0642-7