Exp Clin Endocrinol Diabetes 2018; 126(09): 577-583
DOI: 10.1055/s-0043-119985
Article
© Georg Thieme Verlag KG Stuttgart · New York

Development of Obesity-Associated Comorbidities Post Bariatric Surgery with a Special Focus on Diabetes Remission and Short-Term Relapse

Nina Riedel*
1   Department for Endocrinology and Diabetology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
,
Anne Lautenbach*
1   Department for Endocrinology and Diabetology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
,
Jan Wilhelm Wienecke
1   Department for Endocrinology and Diabetology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
,
Oliver Mann
2   Department of General, Visceral and Thoracic Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
,
Jörg Flitsch
3   Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
,
Jens Aberle
1   Department for Endocrinology and Diabetology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
› Author Affiliations
Further Information

Publication History

received 10 July 2017
revised 18 September 2017

accepted 18 September 2017

Publication Date:
08 November 2017 (online)

Abstract

Purpose The purpose of this study is to study a heterogeneous group of obese patients undergoing Bariatric surgery(BS) and its impact on glycemic control. Secondary endpoints include changes in lipid profile and albuminuria. BS has shown to effectively reduce body-weight. However, the impact on obesity-related comorbidities varies strongly between individuals. Especially postoperative short- and long-term improvement of Diabetes is an active area of investigation.

Methods We conducted a retrospective analysis from baseline to 24 months post bariatric surgery in our interdisciplinary obesity outpatient-clinic. Follow-up data was collected from 215 patients who had undergone either Roux-en-Y gastric bypass or Sleeve Gastrectomy. The prevalence of and changes in the major obesity-related comorbidities and concurrent medication were assessed.

Results Standard parameters of diabetic control showed a U-shaped curve with initial improvement after six months, but with a gradual worsening after the first year of follow-up. Weight loss resulted in dose reduction of oral antidiabetic medication and insulin in 85% and 100% of patients, respectively. With weight loss, a significant improvement in lipid profile one year after surgery was seen. Subgroup analysis demonstrated gender- and age-dependent differences in overall benefit.

Conclusions Current data on diabetes remission might be too optimistic and close follow-up should be provided to prevent gradual worsening of glucose metabolism after BS.

* These authors contributed equally to this work.