Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6months following bariatric surgery

Mallipedhi, Akhila; Min, Thinzar; Prior, Sarah L.; MacIver, Claire; Luzio, Stephen Denis; Dunseath, Gareth; Bracken, Richard M.; Islam, Saiful; Barry, Jonathan; Caplin, Scott; Stephens, Jeffrey W.

doi:10.1016/j.metabol.2015.08.009

Cited by 15 publications

(6 citation statements)

References 36 publications

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“…This finding is being probably related to their impaired diabetes remission after bariatric surgery. C-peptide is considered an important determinant of T2D remission since it constitutes a direct measure of insulin production and provides an accurate measure of pancreatic β-cell reserve [48,49]. Higher C-peptide levels have been described in subjects with T2D remission compared to those without remission suggesting that preoperative C-peptide determination may be a useful estimator of T2D remission after bariatric surgery [50].…”

Section: Discussionmentioning

confidence: 99%

Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

et al. 2019

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Bariatric surgery remains the most effective option for achieving important and sustained weight loss. We explored the effects of Roux-en-Y gastric bypass (RYGB) on the circulating levels of adiponectin, leptin, and the adiponectin/leptin (Adpn/Lep) ratio in patients with obesity and type 2 diabetes (T2D). Twenty-five T2D volunteers undergoing RYGB were included in the study, and further subclassified as patients that responded or not to RYBG, regarding remission of T2D. Anthropometric and biochemical variables were evaluated before and after RYGB. Obese patients with T2D exhibited an increase (p < 0.0001) in the Adpn/Lep ratio after RYGB. Changes in the Adpn/Lep ratio correlated better with changes in anthropometric data (p < 0.001) than with the variations of adiponectin or leptin alone. Multiple regression analysis revealed that the change in the Adpn/Lep ratio in patients with T2D was an independent predictor of the changes in body mass index (p < 0.001) and body fat percentage (p = 0.022). However, the Adpn/Lep ratio did not differ between individuals with or without T2D remission after RYGB. In summary, the current study demonstrated that after weight and body fat loss following RYGB, the Adpn/Lep ratio increased in patients with obesity and T2D.

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Section: Discussionmentioning

confidence: 99%

Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

et al. 2019

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“…This was perhaps due to the different biological half-lives of insulin and C peptide (the halflife of insulin is 4.8 min, and of C peptide 11 min). Serum insulin content is partly dependent on body mass and the degree of insulin resistance, while C-peptide reflects islet β cell reserves and may offer a more accurate measurement of β cell insulin response to glucose (Mallipedhi et al, 2015). Therefore, this data suggests that AAPs and their simulated hydrolysate might relieve hyperglycemia by improving islet function.…”

Section: Discussionmentioning

confidence: 88%

Antioxidant and anti-diabetic effects of Auricularia auricular polysaccharides and their degradation by artificial gastrointestinal digestion - Bioactivity of Auricularia auricular polysaccharides and their hydrolysates [pdf]

Lu¹,

Yu²,

Shao³

et al. 2018

Acta Sci Pol Technol Aliment

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Background. Auricularia auricular polysaccharides (AAPs) derived from the dried fruit body of A. auricular are valuable compounds with many bioactivities. This research aimed to investigate the antioxidant and antidiabetic activities of these polysaccharides and their artificial gastrointestinal fluid hydrolysates (AAPHs). Material and methods. Artificially simulated gastrointestinal fluid was used to obtain polysaccharide-derived fragments, and a rat model of type 2 diabetes mellitus (T2DM) using a high-fat diet and low-dose streptozotocin (STZ) was established to assess their antioxidant and anti-diabetic effects. Results. It was found that AAPs and AAPHs were both heteropolysaccharides and were comprised of arabinose, xylose, mannose, 2-deoxy-glucose, glucose and glucosamine, but at different mole ratios. AAPHs was purified by Sephadex G-100 chromatography to produce three fractions, namely, AAPHs1, AAPHs2, and AAPHs3. The molecular weights of these three fractions were 320, 169, and 62 kDa respectively. Both AAPs and AAPHs exhibited the evident ability to enhance the activities of antioxidant enzymes and the level of GSH, while increasing the content of liver glycogen and plasma C-peptide compared with the diabetic model group (p < 0.05). Furthermore, AAPHs could cause a marked improvement in glucose-stimulated GLP-1 secretion from 0 min to 30 min (p < 0.05). Conclusions. The possible mechanism was that AAPHs could partly restore the STZ-induced impairment of GLP-1 secretion, and inhibit the oxidative stress pathway, and thereby alleviate the progression of diabetes. This data demonstrated that the molecular mole ratio and molecular weight had a definite effect on antioxidant and anti-diabetic activities.

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“…However, it is possible that islet cell antibody positivity may have implications for the effects of bariatric surgery on diabetes outcomes. In patients with type 2 diabetes, lower preoperative C-peptide levels have been associated with a less favorable response to bariatric surgery in respect to glycemic control [33]. Further research is needed to determine whether the presence of islet cell antibodies impacts the efficacy of bariatric surgery.…”

Section: Discussionmentioning

confidence: 99%

The Role of Laboratory Testing in Differentiating Type 1 Diabetes from Type 2 Diabetes in Patients Undergoing Bariatric Surgery

et al. 2017

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Background It may be difficult to distinguish between adults with type 1 diabetes and type 2 diabetes by clinical assessment. In patients undergoing bariatric surgery, it is critical to correctly classify diabetes subtype to prevent adverse perioperative outcomes including diabetic ketoacidosis. This study aimed to determine whether testing for C-peptide and islet cell antibodies during preoperative evaluation for bariatric surgery could improve the classification of type 1 versus type 2 diabetes compared to clinical assessment alone. Methods This is a retrospective analysis of the Improving Diabetes through Lifestyle and Surgery trial, which randomized patients with clinically diagnosed type 2 diabetes and BMI 30–40 kg/m2 to medical weight loss or bariatric surgery; one participant was discovered to have type 1 diabetes after experiencing postoperative diabetic ketoacidosis. Using blood samples collected prior to study interventions, we measured islet cell antibodies and fasting/meal-stimulated C-peptide in all participants. Results The participant with type 1 diabetes was similar to the 11 participants with type 2 diabetes in age at diagnosis, adiposity, and glycemic control but had the lowest C-peptide levels. Among insulin-treated participants, fasting and stimulated C-peptide correlated strongly with the C-peptide area-under-the-curve on mixed meal tolerance testing (R = 0.86 and 0.88, respectively). Three participants, including the one with type 1 diabetes, were islet cell antibody positive. Conclusions Clinical characteristics did not correctly identify type 1 diabetes in this study. Preoperative C-peptide testing may improve diabetes classification in patients undergoing bariatric surgery; further research is needed to define the optimal C-peptide thresholds.

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Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6months following bariatric surgery

Abstract: This 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.

Cited by 15 publications

References 36 publications

Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

Increase of the Adiponectin/Leptin Ratio in Patients with Obesity and Type 2 Diabetes after Roux-en-Y Gastric Bypass

Antioxidant and anti-diabetic effects of Auricularia auricular polysaccharides and their degradation by artificial gastrointestinal digestion - Bioactivity of Auricularia auricular polysaccharides and their hydrolysates [pdf]

The Role of Laboratory Testing in Differentiating Type 1 Diabetes from Type 2 Diabetes in Patients Undergoing Bariatric Surgery

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