Comparison of glucose homeostasis parameters between patients with high and low risk of diabetes at 6 weeks and 6 months after sleeve gastrectomy.

BACKGROUND

The changes in glucose homeostasis after sleeve gastrectomy (SG) for patients with high (HRD) and low risk (LRD) of developing diabetes have not been investigated.

OBJECTIVE

To compare the glucose homeostasis parameters between patients with HRD and LRD after SG.

SETTING

University hospital in Greece.

METHODS

Thirteen patients were categorized as HRD (9 females, mean body mass index 46.3±1.6 kg/m) and 10 as LRD (8 females, mean body mass index 45.4±1.7 kg/m) based on a preoperative 2-hour oral glucose tolerance test (OGTT). OGTT was repeated 6 weeks and 6 months postoperatively. OGTT-derived indices of insulin secretion, insulin sensitivity, and β-cell function (oral disposition index [ODI]) were calculated.

RESULTS

Preoperatively, in the HRD group, fasting and postload glucose levels were higher and the ODIs were lower compared with those in the LRD group. Six weeks postoperatively, glucose levels and ODIs were not different between the 2 groups. However, 6 months postoperatively, the HRD group had demonstrated higher postload glucose levels and lower ODI (0-30) and ODI (0-120) compared with the LRD group. Six weeks postoperatively, insulin levels, early insulin secretion, and insulin resistance indices were decreased compared with preoperative levels only in the HRD group. Six months postoperatively, ODIs and insulin sensitivity indices improved in both groups compared with baseline.

CONCLUSION

Six months after SG, glucose levels and ODIs improved for both HRD and LRD patients; however, postprandial glucose levels and ODI (0-30) and ODI (0-120) in HRD patients did not return to LRD levels. Moreover, during the first 6 postoperative weeks, the changes in glucose homeostasis parameters compared with preoperative levels were different for HRD and LRD patients.