Predicting Diabetes Control After Surgery

Gastric bypass for type 2 diabetes may lead to remission in obese patients with high C peptide levels

(RxWiki News) Study after study has shown that weight loss surgery can reverse diabetes in many patients. However, it is still not entirely clear which patients will benefit the most.

Recent findings suggested that type 2 diabetes patients who are severely obese, have had diabetes for less than 4 years and who have high insulin levels may have a good chance of diabetes remission (lessening of symptoms) after weight loss surgery.

"Ask your doctor if you qualify for weight loss surgery."

If doctors can predict which patients with type 2 diabetes will have the most improvement in blood sugar control after weight loss surgery, they may find it easier to select patients who qualify for surgery, said John B. Dixon, PhD, of Monash University in Australia, and colleagues in background information to their study.

Dr. Dixon and his fellow researchers set out to find factors that could predict diabetes remission in patients before they underwent surgery.

The researchers found blood sugar control after surgery was related to patients' BMI (a measure of body fat using height and weight), time spent living with diabetes and C-peptide levels (a measure of insulin levels) before surgery.

Specifically, the main predictors of remission before weight loss surgery were:

  • diabetes duration of less than 4 years
  • a BMI of more than 35 kg/m2 - which means a person is very obese
  • fasting C-peptide level of more than 2.9 ng/mL - a normal fasting C-peptide level usually falls between 0.5 and 2.0 ng/mL

The researchers also found patients' time spent with diabetes (at different cutoff points) and C-peptide levels predicted those patients who did not reach an HbA1c level of 7 percent or less. HbA1c is a measure of blood sugar over 3 months. It is generally recommended diabetes patients try to get HbA1c below 7 percent.

In addition, the percentage of weight loss after surgery predicted remission and poor outcomes alike.

For their research, Dr. Dixon and colleagues studied 154 ethnic Chinese individuals with type 2 diabetes. At 1 year after surgery, 107 participants (69.5 percent) achieved remission.

According to the authors, these results support past findings in non-Asian populations.

The study was published October 1 in Diabetes Care, a journal of the American Diabetes Association.

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Review Date: 
October 4, 2012