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• W2148448483 abstract "Aim To identify the metabolic determinants of type 2 diabetes non‐remission status after bariatric surgery at 12 and 24 months. Methods A total of 40 adults [mean ± sd body mass index 36 ± 3 kg/m 2 , age 48 ± 9 years, glycated haemoglobin ( HbA1c ) 9.7 ± 2%) undergoing bariatric surgery [Roux‐en‐Y gastric bypass ( RYGB ) or sleeve gastrectomy ( SG )] were enrolled in the present study, the Surgical Treatment and Medication Potentially Eradicate Diabetes Efficiently ( STAMPEDE ) trial. Type 2 diabetes remission was defined as HbA1c <6.5% and fasting glucose <126 mg/dl (i.e. <7 mmol/l) without antidiabetic medication. Indices of insulin secretion and sensitivity were calculated from plasma glucose, insulin and C‐peptide values during a 120‐min mixed‐meal tolerance test. Body fat, incretins (glucagon‐like polypeptide‐1, gastric inhibitory peptide, ghrelin) and adipokines [adiponectin, leptin, tumour necrosis factor‐α, high‐sensitivity C‐reactive protein (hs‐ CRP )] were also assessed. Results At 24 months, 37 patients had available follow‐up data ( RYGB , n = 18; SG , n = 19). Bariatric surgery induced type 2 diabetes remission rates of 40 and 27% at 12 and 24 months, respectively. Total fat/abdominal fat loss, insulin secretion, insulin sensitivity and β‐cell function (C‐peptide 0–120 /glucose 0–120 × Matsuda index) improved more in those with remission at 12 and 24 months than in those without remission. Incretin levels were unrelated to type 2 diabetes remission, but, compared with those without remission, hs‐ CRP decreased and adiponectin increased more in those with remission. Only baseline adiponectin level predicted lower HbA1c levels at 12 and 24 months, and elevated adiponectin correlated with enhanced β‐cell function, lower triglyceride levels and fat loss. Conclusions Smaller rises in adiponectin level, a mediator of insulin action and adipose mass, characterize type 2 diabetes non‐remission up to 2 years after bariatric surgery. Adjunctive strategies promoting greater fat loss and/or raising adiponectin may be key to achieving higher type 2 diabetes remission rates after bariatric surgery." @default.
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• W2148448483 date "2014-09-14" @default.
• W2148448483 modified "2023-10-17" @default.
• W2148448483 title "Attenuated improvements in adiponectin and fat loss characterize type 2 diabetes non-remission status after bariatric surgery" @default.
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• W2148448483 doi "https://doi.org/10.1111/dom.12376" @default.
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