title: Preoperative Beta Cell Function Is Predictive of Diabetes Remission After Bariatric Surgery.
abstract: Bariatric surgery can improve glucose metabolism in obese patients with diabetes, but the factors that can predict diabetes remission are still under discussion. The present study aims to examine the impact of preoperative beta cell function on diabetes remission following surgery.
  
  
  
  We investigated a cohort of 363 obese diabetic patients who underwent bariatric surgery. The impact of several preoperative beta cell function indexes on diabetes remission was explored through bivariate logistic regression models.
  
  
  
  Postoperative diabetes remission was achieved in 39.9 % of patients. Younger patients (p < 0.001) and those with lower HbA1c (p = 0.001) at the baseline evaluation had higher odds of diabetes remission. Use of oral anti-diabetics and insulin therapy did not reach statistical significance when they were adjusted for age and HbA1c. Among the evaluated indexes of beta cell function, higher values of insulinogenix index, Stumvoll first- and second-phase indexes, fasting C-peptide, C-peptide area under the curve (AUC), C-peptide/glucose AUC, ISR (insulin secretion rate) AUC, and ISR/glucose AUC predicted diabetes remission even after adjustment for age and HbA1c. Among them, C-peptide AUC had the higher discriminative power (AUC 0.76; p < 0.001).
  
  
  
  Patients' age and preoperative HbA1c can forecast diabetes remission following surgery. Unlike other studies, our group found that the use of oral anti-diabetics and insulin therapy were not independent predictors of postoperative diabetes status. Preoperative beta cell function, mainly C-peptide AUC, is useful in predicting diabetes remission, and it should be assessed in all obese diabetic patients before bariatric or metabolic surgery.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. pedrobsouteiro@gmail.com.
authors.forename: Pedro
authors.initials: P
authors.lastname: Souteiro
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Sandra
authors.initials: S
authors.lastname: Belo
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
authors.forename: João Sérgio
authors.initials: JS
authors.lastname: Neves
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Magalhães
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Rita Bettencourt
authors.initials: RB
authors.lastname: Silva
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Sofia Castro
authors.initials: SC
authors.lastname: Oliveira
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Maria Manuel
authors.initials: MM
authors.lastname: Costa
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Saavedra
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Oliveira
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Filipe
authors.initials: F
authors.lastname: Cunha
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Eva
authors.initials: E
authors.lastname: Lau
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: César
authors.initials: C
authors.lastname: Esteves
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.|Multidisciplinary Group for Surgical Management of Obesity, Centro Hospitalar São João, Porto, Portugal.
authors.forename: Paula
authors.initials: P
authors.lastname: Freitas
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.|Multidisciplinary Group for Surgical Management of Obesity, Centro Hospitalar São João, Porto, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Varela
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Multidisciplinary Group for Surgical Management of Obesity, Centro Hospitalar São João, Porto, Portugal.
authors.forename: Joana
authors.initials: J
authors.lastname: Queirós
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar São João, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.|Institute for Research and Innovation in Health, University of Porto, Porto, Portugal.
authors.forename: Davide
authors.initials: D
authors.lastname: Carvalho
mesh_terms: D000328:Adult; D050110:Bariatric Surgery; D001786:Blood Glucose / Q000378:metabolism; D002096:C-Peptide / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007328:Insulin / Q000378:metabolism; D050417:Insulin-Secreting Cells / Q000378:metabolism / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery; D011184:Postoperative Period; D057234:Preoperative Period; D012074:Remission Induction; D012189:Retrospective Studies; D015431:Weight Loss / Q000502:physiology
chemical_list: D001786:Blood Glucose; D002096:C-Peptide; D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Bariatric surgery; C-peptide; Diabetes mellitus; Insulin-secreting cells; Metabolic surgery; Obesity