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

• Published in: Metabolism, clinical and experimental clinical and experimental, 2015-11, Vol.64 (11), p.1556-1563
• Main Authors: Mallipedhi, Akhila, Min, Thinzar, Prior, Sarah L., MacIver, Claire, Luzio, Steve D., Dunseath, Gareth, Bracken, Richard M., Islam, Saiful, Barry, Jonathan D., Caplin, Scott, Stephens, Jeffrey W.
• Format: Article
• Language: English
• Subjects: Area under curve; Bariatric surgery; C-peptide; Insulin; Type 2 diabetes
• ISSN: 0026-0495; 1532-8600
• DOI: 10.1016/j.metabol.2015.08.009

Bariatric 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 6months after bariatric surgery regardless of the operation type. A 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 6months post-operatively. A responder was defined with a fasting glucose 5.2ng/mL [1.73nmol/L]) had a sensitivity and negative predictive value of 100% to predict T2DM remission. Logistic regression showed that 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%. This study demonstrated that static (fasting) and dynamic (AUC, 2-hour) C-peptide measurements predict T2DM resolution 6months following bariatric surgery. This work provides insight into C-peptide dynamics as a predictor of response to bariatric surgery.