title: Failed Surgical Weight Loss Does Not Necessarily Mean Failed Metabolic Effects.
abstract: The metabolic profile of patients after a failed surgical weight loss procedure is unknown. Long-term clinical outcomes of 31 obese diabetes patients with post-bariatric surgery excess weight loss of ≤25% were assessed. At a median follow-up of 6 years (range, 5-9 years) after surgery, remission and clinical improvement of diabetes occurred in seven (23%) and 13 (42%) patients, respectively. A long-term mean total weight loss of 7.0±4.7% and excess weight loss of 13.7±8.5% were associated with a mean reduction in fasting blood glucose level, from 158.9±66.7 to 128.4±35.3 mg/dL (P=0.03), and a significant decrease in diabetes medication requirements (P<0.001). A significant decrease in systolic blood pressure (11.1±23.4 mm Hg, P=0.01) and level of circulating triglycerides (35.7±73.4 mg/dL, P=0.04) was also observed after surgery. A modest surgical weight loss in the range of 5-10% of initial weight was associated with significant improvement in cardiometabolic risk factors of morbidly obese diabetes patients. The markedly improved glycemic control (65% remission or clinical improvement) may be partly explained by weight-independent antidiabetes mechanisms of certain bariatric surgical procedures.
authors.affiliation: 1 Bariatric and Metabolic, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Ali
authors.initials: A
authors.lastname: Aminian
authors.affiliation: 1 Bariatric and Metabolic, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Jamal
authors.affiliation: 1 Bariatric and Metabolic, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Toms
authors.initials: T
authors.lastname: Augustin
authors.affiliation: 1 Bariatric and Metabolic, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Ricard
authors.initials: R
authors.lastname: Corcelles
authors.affiliation: 2 Endocrinology and Metabolism Institutes, Cleveland Clinic , Cleveland, Ohio.
authors.forename: John P
authors.initials: JP
authors.lastname: Kirwan
authors.affiliation: 1 Bariatric and Metabolic, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Schauer
authors.affiliation: 1 Bariatric and Metabolic, Cleveland Clinic , Cleveland, Ohio.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Brethauer
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008055:Lipids