1. Biochemical Correlates of Bariatric-Responsive Diabetes.
- Author
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Joel Faintuch, Camila M. Yamaguchi, Maria Carolina G. Dias, Marco A. Santo, Jacob J. Faintuch, and Ivan Cecconello
- Subjects
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CLINICAL biochemistry , *DIABETES , *OVERWEIGHT persons , *COHORT analysis , *HEALTH outcome assessment , *BODY mass index , *GLUCOSE , *GLYCOSYLATED hemoglobin - Abstract
AbstractObjective:In a prospective observational cohort study, the biochemical profile of bariatrically managed diabetes was documented, aiming to assess its association with clinical outcome.Methods:The population (n= 82; age, 50.7 ± 10.3 years; 92.7% women; followed up for 93 ± 34 months) was stratified as responsive diabetes (Group I) (36.6%, 30 of 82) and controls without diabetes (Group II) (57.3%, 47 of 82). A few refractory subjects were identified in this cohort (Group III [refractory diabetes], 6.3%, five of 82). Nonbariatric overweight and obese diabetes subjects with similar follow-up (n= 21) were documented as well. Main outcome measures were diabetes regression, body mass índex (BMI), glucose, glycosylated hemoglobin A1c (HbA1c), serum lipids, and white blood cell count (WBC) count.Results:Preoperative BMI was somewhat discrepant among operated groups but leveled off from 2 years on. Baseline WBC count, total cholesterol, low-density lipoprotein-cholesterol, blood glucose, and HbA1c were higher in responsive subjects, but a downward shift occurred, without differences regarding controls, in the subsequent period. Conservatively managed diabetes displayed favorable changes of some lipid fractions, but not glucose, HbA1c, total cholesterol, or WBC count.Conclusions:Diabetes regression rate was 94.3% at 5 years and 84.7% at around 8 years. In responsive patients, both BMI and biochemical indices normalized in the first 2 years and followed a stable path thereafter. Nonoperative treatment was unable to reduce HbA1c, glucose, or WBC count, and HbA1c was a clear prognostic marker of persistent disease in surgical cases. Further studies emphasizing the metabolic and inflammatory signature of obesity-related diabetes are worthwhile. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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