Journal article 1412 views 371 downloads
Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery
,
Claire MacIver,
Steve D. Luzio,
Gareth Dunseath ,
Richard Bracken ,
Saiful Islam ,
Jonathan D. Barry,
Scott Caplin,
Jeffrey Stephens ,
Steve Luzio
Metabolism
Swansea University Authors:
Sarah Prior , Gareth Dunseath , Richard Bracken , Saiful Islam , Jeffrey Stephens , Steve Luzio
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© 2016. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
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DOI (Published version): 10.1016/j.metabol.2015.08.009
Abstract
Background and AimsBariatric surgery results in the remission of type 2 diabetes mellitus (T2DM) in morbidly obese subjects. The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery r...
| Published in: | Metabolism |
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| Published: |
2015
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa22971 |
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| Abstract: |
Background and AimsBariatric surgery results in the remission of type 2 diabetes mellitus (T2DM) in morbidly obese subjects. The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery regardless of the operation type.Methods and ResultsA non-randomized prospective study of 24 participants with T2DM undergoing bariatric surgery. Measurements of fasting and 2-hour plasma glucose, insulin, C-peptide and measures of insulin sensitivity were recorded temporally during an oral glucose tolerance test pre-operatively and 6 months post-operatively. A responder was defined with a fasting glucose < 5.6mmol/L and HBA1c < 6.0% postoperatively. Within the sample there were 11 responders and 13 non-responders at 6 months. There was a significant difference in the duration of diabetes between the groups. Fasting C-peptide (P≤0.05) and 2-hour C-peptide (P≤0.05) were higher in responders compared to non-responders. Significantly higher C-peptide levels were observed preoperatively at all time points for responders, with significantly higher area under the curve (AUC0–60 and AUC0–120). Using the lower quartiles for C-peptide levels, both fasting C-peptide (> 2.5ng/mL [0.83nmol/L]) and 2-hour C-peptide (> 5.2ng/mL [1.73nmol/L]) had a sensitivity and negative predictive value of 100% to predict T2DM remission. Logistic regression showed C-peptide, duration of diabetes and BMI were associated with response. The area under the ROC curve was 0.94 and a regression model predicted diabetes remission with a sensitivity of 85.7% and a specificity of 88.9%.ConclusionsThis study demonstrated that static (fasting) and dynamic (AUC, 2-hour) C-peptide measurements predict T2DM resolution 6 months following bariatric surgery. This work provides insight into C-peptide dynamics as a predictor of response to bariatric surgery. |
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| College: |
Faculty of Medicine, Health and Life Sciences |