ECE2018 Poster Presentations: Diabetes, Obesity and Metabolism Obesity (78 abstracts)
The preoperative diagnosis of type 2 diabetes in the absence of antidiabetic treatment is associated with a worse performance after gastric-bypass compared to patients without diabetes
Javier Gargallo 1 , Sara Laguna 2 , María Llavero 1 , Carolina M Perdomo 1 , Victor Valentí 1 , Javier Escalada 1 , Javier Gómez-Ambrosi 1 , Camilo Silva 1 , Gema Frühbeck 1 & Javier Salvador 1
1University Clinic of Navarra, Pamplona, Spain; 2Hospital Calahorra, Calahorra, Spain.
Objectives and methods: The mechanism that explains the different weight response to various treatments in obese type 2 diabetes (DM2) patients, compared to those without diabetes, is still unknown. In order to establish the weight response to Roux-en-Y Gastric Bypass (RYGB), 268 patients with morbid obesity (IMC 45.4±0.4 kg/m2) were classified by OGTT as having normal glucose tolerance (Grupo A. n=107), prediabetes (Grupo B. n=96) and recently diagnosed DM2 (Grupo C. n=65). No antidiabetic drugs were given in any patient. Anthropometry, body composition (Bod-Pod) and HOMA-R index were assessed at baseline and 1, 6, 12, 18, 24, 36, 48, 60 and 72 months after surgery in all patients.
Results: The mean nadir BMI (kg/m2) occurred 24 m after RYGB in group A (28.8±0.6 kg/m2) and 18 m after surgery in groups B (28.3±0.7 kg/m2) and C (30.8±0.7 kg/m2). The mean nadir of percent body fat was greater than 30% in all three groups (A: 33.8±1.2%; B:35.9±1.4; C:36.5±1.3%). The percentage reduction of BMI respect to baseline was lower in group C compared to group A at 24 m (30.3±3.5 vs. 34.4±1.3%; P<0.01), 36 m (28.1±4.8 vs. 33.2±1.6%; P<0.01) and 48 m post RYGB (25.7±3.9 vs. 31.7±1.3%; P<0.05). The percentage reduction in fat mass (%) was lower in group C compared to group A at 12 m (28.1±1.7 vs. 35±1.7%; P<0.05), 18 m (27.4±1.9 vs. 36.2±2.2%; P<0.01), 24 m (21.9±1.6 vs. 33.9±2.5%; P<0.01) and 48 m (13.8±2.3 vs. 30.3±3.5%; P<0.001). Group A and B did not differ in any parameter. HOMA-R index, which was elevated before surgery in all groups, was normalized after 6 months from RYGB without any differences between the different groups.
Conclusions: After RYGB, and when compared with normal glucose tolerant and prediabetic subjects, patients with DM2 have lower weight loss and fat mass reduction, despite they did not receive any antidiabetic treatment, excluding the participation of this factor. These results suggest that DM2 is associated with poorer results following RYGB. There were no differences between groups in HOMA-R index, suggesting that variations in insulin resistance do not play a role in this phenomenon.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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