Glycemic control in diabetic patients after bariatric surgery.
BACKGROUND
Morbid obesity is associated with a high prevalence of diabetes mellitus, and weight loss is fundamental to improve glycemic control. The aim of the present study was to evaluate the impact of weight reduction during the late postoperative period (> or = 12 months) after gastric bypass on the glycemic control of diabetic patients.


METHODS
Fasting glycemia (glucose oxidase) and glycohemoglobin A1c (enzymatic fluorescence, reference value: 4-6%) were determined before and after surgery. Results were compared by the Student t-test for paired samples (P <0.05).


RESULTS
23 women and 8 men with diabetes, with a mean follow-up of 27.2 months and a mean age of 42.5 years (30-68), were studied. Before surgery, mean +/- SD weight, BMI, excess weight, glycemia and glycohemoglobin were 135.9+/-11.6 kg, 51.8+/-6.4 kg/m2, 68.3+/-14.5 kg, 173+/-71.2 mg/dl, and 7.4+/-1.9%, respectively. After surgery, mean weight, BMI, excess weight, percent weight loss, percent excess weight loss, glycemia and glycohemoglobin were 89.7+/-8.8 kg, 35+/-4.5 kg/m2, 24.6+/-11.6 kg, 32.6%+/-1.8 (12.6-46.5%), 64.7+/-18.3%, 98+/-17.3 mg/dl (P <0.01), and 5.4+/-1.0% (P <0.05), respectively. Oral anti-diabetic drug and/or insulin treatment was discontinued in 89.2% of the patients. After surgery, 90.3% of the patients maintained glycohemoglobin A1c levels <7.0%.


CONCLUSIONS
Weight loss led to a significant and sustained improvement of glycemic control in these patients submitted to bariatric surgery.
Diniz
Maria de Fátima Haueisen Sander
Mde F
Serviço de Endocrinologia e Metabologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. mfhsdiniz@ufmg.br
Diniz
Marco Túlio Costa
MT
Sanches
Soraya Rodrigues Almeida
SR
de Almeida Salgado
Patrícia Paz Cabral
PP
Valadão
Maristane Mendes Andrade
MM
Freitas
Cláudia Patrícia
CP
Vieira
David José
DJ
D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
D001786:Blood Glucose; D006442:Glycated Hemoglobin