Development of Obesity-Associated Comorbidities Post Bariatric Surgery with a Special Focus on Diabetes Remission and Short-Term Relapse

Exp Clin Endocrinol Diabetes. 2018 Sep;126(9):577-583. doi: 10.1055/s-0043-119985. Epub 2017 Nov 8.

Abstract

Purpose: The purpose of this study is to study a heterogeneous group of obese patients undergoing Bariatric surgery(BS) and its impact on glycemic control. Secondary endpoints include changes in lipid profile and albuminuria. BS has shown to effectively reduce body-weight. However, the impact on obesity-related comorbidities varies strongly between individuals. Especially postoperative short- and long-term improvement of Diabetes is an active area of investigation.

Methods: We conducted a retrospective analysis from baseline to 24 months post bariatric surgery in our interdisciplinary obesity outpatient-clinic. Follow-up data was collected from 215 patients who had undergone either Roux-en-Y gastric bypass or Sleeve Gastrectomy. The prevalence of and changes in the major obesity-related comorbidities and concurrent medication were assessed.

Results: Standard parameters of diabetic control showed a U-shaped curve with initial improvement after six months, but with a gradual worsening after the first year of follow-up. Weight loss resulted in dose reduction of oral antidiabetic medication and insulin in 85% and 100% of patients, respectively. With weight loss, a significant improvement in lipid profile one year after surgery was seen. Subgroup analysis demonstrated gender- and age-dependent differences in overall benefit.

Conclusions: Current data on diabetes remission might be too optimistic and close follow-up should be provided to prevent gradual worsening of glucose metabolism after BS.

MeSH terms

  • Adult
  • Bariatric Surgery*
  • Blood Glucose / metabolism*
  • Comorbidity
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias / blood*
  • Dyslipidemias / epidemiology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Obesity / epidemiology
  • Obesity / surgery*
  • Outcome Assessment, Health Care*
  • Retrospective Studies
  • Weight Loss*

Substances

  • Blood Glucose