Bariatric surgery significantly decreases the prevalence of type 2 diabetes mellitus and pre-diabetes among morbidly obese multiethnic adults: long-term results.

BACKGROUND

Type 2 diabetes (T2DM) and obesity are codependent epidemics that disproportionately affect ethnic minorities. Recent studies have shown that in non-Hispanic whites, bariatric surgical procedures successfully reverse or improve abnormal glucose metabolism, yet little is known about the results of bariatric surgery in Hispanic and other ethnic minority adults with T2DM.

STUDY DESIGN

A retrospective analysis of 1,603 adults (77% female, 66% Hispanic, mean age at surgery 45.1 years [SD 11.6 years]) who underwent bariatric surgery from 2002 to 2010 was conducted. A total of 377 subjects had diagnosed T2DM, 107 had fasting plasma glucose (FPG) ≥126 mg/dL but were not on T2DM medication, 276 were pre-diabetic (FPG = 100 to 125 mg/dL), and 843 had normal FPG. Pre-surgery and 6, 12, 24, and 36 months post-surgery comparative-means analyses of weight, body mass index, estimated weight loss, hemoglobin A1c, and FPG were conducted via repeated-measures analysis.

RESULTS

By 1 year and through 3 years post-surgery, all groups had normal FPG. Patients with undiagnosed diabetes had a 43% FPG decrease followed by diagnosed diabetics (33%). Patients with diagnosed diabetes showed a slightly greater loss in hemoglobin A1c (2.30%) versus undiagnosed diabetics (2.13%). Patients with pre-diabetes saw the most dramatic loss in weight (47.00 kg), followed by patients with undiagnosed diabetes (46.62 kg), normal FPG (43.14 kg), and patients with diagnosed diabetes (41.39 kg) (p < 0.0001 for all up to 24 months).

CONCLUSIONS

Bariatric surgery results in significant long-term weight loss and improvement in FPG levels among ethnically diverse adults. Bariatric surgery has the potential to be an effective treatment option for weight loss and chronic disease risk improvements in this demographic.