title: Adults with long-duration type 2 diabetes have blunted glycemic and β-cell function improvements after bariatric surgery.
abstract: OBJECTIVE
  This study investigated the effect of type 2 diabetes duration on glucose regulation 24 months post-bariatric surgery.
  
  
  METHODS
  Twenty-seven adults with short- (<5 years) and long-duration (≥10 years) type 2 diabetes received a mixed-meal tolerance test at baseline and 24 months postsurgery. Body weight, insulin sensitivity, first- and second-phase meal-stimulated insulin secretion, disposition index (i.e., DI or pancreatic β-cell function), and incretin responses were examined.
  
  
  RESULTS
  Adults with short-duration type 2 diabetes had better HbA(1c), greater insulin secretory capacity, and greater DI compared with adults with long-duration type 2 diabetes, despite similar weight loss and incretin responses. Diabetes duration correlated with smaller improvements in HbA(1c) and DI but not weight loss.
  
  
  CONCLUSIONS
  Enhanced β-cell function characterizes the effect of bariatric surgery in adults with diabetes for <5 years, independent of weight loss or incretins. Additional therapy postsurgery may be required to improve glycemia for people with long-standing type 2 diabetes.
authors: Department of Endocrinology, Diabetes, and Metabolism, Cleveland Clinic, Cleveland, Ohio, USA; Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, USA.
authors: Vishesh
authors: V
authors: Khanna
authors: Steven K
authors: SK
authors: Malin
authors: James
authors: J
authors: Bena
authors: Beth
authors: B
authors: Abood
authors: Claire E
authors: CE
authors: Pothier
authors: Deepak L
authors: DL
authors: Bhatt
authors: Steven
authors: S
authors: Nissen
authors: Richard
authors: R
authors: Watanabe
authors: Stacy A
authors: SA
authors: Brethauer
authors: Philip R
authors: PR
authors: Schauer
authors: John P
authors: JP
authors: Kirwan
authors: Sangeeta R
authors: SR
authors: Kashyap
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D038321:Glycemic Index; D006801:Humans; D054795:Incretins / Q000378:metabolism; D007328:Insulin / Q000378:metabolism; D000078790:Insulin Secretion; D050417:Insulin-Secreting Cells / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies
chemical_list: D054795:Incretins; D007328:Insulin
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