Effect of Bariatric Surgery on Glycemic Profiles in Multi-ethnic Obese Non-diabetic Asians

Abstract Background The effect of bariatric surgery on improvement and remission of type 2 diabetes mellitus (T2D) is well studied. The effect of surgery on glycemic profiles of obese, but non diabetic individuals is unknown. Objectives We aim to study changes in glycemic indices in obese non-diabetics undergoing bariatric surgery and correlate fat mass loss with changes in glycemic profiles. Setting University Hospital, Singapore Methods A prospective database of non T2D patients who underwent bariatric surgery between April 2009 and December 2014 was analyzed. Changes in body weight, fat mass and glycemic profiles including glycated hemoglobin (A1c), C-peptide levels and the Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) were studied at 1 year and 3 years follow-up. Results 133 non-diabetics underwent bariatric surgery in the study period. 29 (21.8%) patients were found to have impaired fasting glycaemia. We observed reductions in mean fat mass from 47.4 ± 12.2 kg pre-operatively to 27.8 ± 11.6 kg at 1 year. Despite mean fat mass regain to 33.9 ± 19.6 kg at 3 years, HOMA-IR improved from severe insulin resistant state of >5.00 (7.13 ± 11.5) pre-operatively to normal ranges of Conclusion Bariatric surgery results in significant sustained weight loss in obese non-diabetics and normalizes A1c and HOMA-IR following surgery. It is a promising modality to prevent or delay the onset of T2D in obese non diabetic patients. Further studies should be conducted in non-diabetics to assess the efficacy of bariatric surgery in prevention of T2D onset in the longer term.