ECE2020 Audio ePoster Presentations Diabetes, Obesity, Metabolism and Nutrition (285 abstracts)
Time to glycemic control – an observational study of 3 different operations
Alper Celik 1 , Sjaak Pouwels 2 , Fatih Can Karaca 1 , Eylem Cagiltay 3 , Surendra Ugale 4 , Ilker Etikan 1 , Deniz Büyükbozkırlı 1 & Yunus Emre Kilic 1
1Metabolic Surgery Clinic; 2Elisabeth Tweesteden Hospital, Intensive Care; 3Department. of Endocrinology, GATA Haydarpașa Training & Research Hospital; 4Department of Bariatric and Metabolic Surgery, Virinchi Hospitals
Background: Medical treatment fails to provide adequate control for many obese patients with type 2 diabetes mellitus (T2DM). A comparative observational study of bariatric procedures was performed to investigate the time at which patients achieve glycemic control within the first 30 postoperative days following sleeve gastrectomy (SG), mini-gastric bypass (MGB), and diverted sleeve gastrectomy with ileal transposition (DSIT).
Methods: Included patients had a body mass index (BMI) ≥30 kg/m2; T2DM for ≥3 years, HbA1C>7% for ≥3 months, and no significant weight change (>3%) within the prior 3 months. Surgical procedures performed were SG (n = 49), MGB (n = 93), and DSIT (n = 109). The primary endpoint was the day within the first postoperative month on which mean fasting capillary glucose levels reached <126 mg/dl. Multivariate logistic regression analysis was used to identify predictors of glycemic control.
Results: The cohort included 251 patients with a mean BMI of 36.04 ± 5.76 kg/m2; age, 52.84 ± 8.52 years; T2DM duration, 13.09 ± 7.54 years; HbA1C, 8.82 ± 1.58%. On the morning of surgery, mean fasting plasma glucose was 177.63 ± 51.3 mg/dl; on day 30, 131.35 ± 28.7 mg/dl (P < 0.05). Mean fasting plasma glucose of <126 mg/dl was reached in the DSIT group (124.36 ± 20.21 mg/dl) on day 29, and in the MGB group (123.61 ± 22.51 mg/dl), on day 30. The SG group did not achieve the target mean capillary glucose level within postoperative 30 days.
Conclusion: During the first postoperative month, glycemic control (<126 mg/dl) was achieved following DSIT and MGB, but not SG. Preoperative BMI and postprandial C-peptide levels were independent predictors of early glycemic control following DSIT.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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