Endocrine Abstracts

Background and Aim: Type 2 diabetes mellitus (T2DM) disparately affects ethnic groups. Prevalence is higher in Asian and Black ethnicities, and these patients suffer increased rates of some diabetes-related complications. Bariatric surgery is an effective treatment for T2DM and can lead to complete diabetes remission. The aim of this study was to assess if T2DM remission rates at 1-year following bariatric surgery vary between different ethnicities.

Methods: We retrospectively reviewed electronic records of 946 patients undergoing bariatric surgery at a UK tertiary centre (2015-2021), identifying 293 patients with T2DM. Data was collected on ethnicity, diabetes duration, diabetes-related complications, and pre- and post-operative weight, HbA1c and use of hypoglycaemic medications. Diabetes remission was defined as HbA1c <48 mmol/mol at least 3 months after cessation of hypoglycaemic medication. Odds ratio (OR) of remission was compared using a chi-squared test.

Results: Our cohort was ethnically diverse; including White (39.3%), mixed (2.7%), Asian (17.8%), Black (14.3%) and other ethnicities (14.7%). Weight loss did not differ between ethnicities. Overall diabetes remission rate at 1-year was 42.3%. Asian patients were least likely to remit (OR 0.84 [95% CI 0.43-1.67]), whilst Black patients were most likely to remit (OR 1.63 [95% CI 0.79-3.21]) as compared to White patients. Logistic regression showed diabetes duration, pre-operative use of insulin and pre-operative HbA1c predicted diabetes remission at 1-year.

Conclusions: At 1-year post-bariatric surgery, T2DM remission rates were highest in Black patients and lowest in Asian patients. However, a more precise estimate of effect size would require a larger sample size. Considering the higher prevalence and complication rates of T2DM in these ethnic minorities, understanding differences in metabolic response to bariatric surgery is invaluable in prioritizing surgery. Further assessment of the role of ethnicity in diabetes remission following bariatric surgery in a multi-centre cohort would be vital to develop our initial findings.