What is the best predictor of glucose metabolism deterioration after bariatric surgery?

Weight regain measured as percentage of maximum weight lost (%MWL) appears to be a better predictor of postoperative glucose metabolism deterioration within 3 years than other quantifiers in patients with obesity and type 2 diabetes mellitus (T2DM) who underwent bariatric surgery, according to a China study. Of note, the optimal cutoff point is 20 percent MWL.

A team of researchers compared measures of weight regain and their association with glucose metabolism deterioration within 3 years following bariatric surgery. In this study, they assessed a retrospective cohort of 249 patients with obesity and T2DM who underwent bariatric surgery and followed them for up to 3 years.

Weight regain was quantified by the following: weight changes, body mass index (BMI) changes, percentage of presurgery weight, percentage of nadir weight, and %MWL.

Glucose metabolism deterioration was characterized by a change from an absence of antidiabetic medication use to use, or absence of insulin use to use, or an increase in glycated haemoglobin by at least 0.5 percent to 5.7 percent or greater.

The C-index of glucose metabolism deterioration as indicated by %MWL demonstrated better discriminatory capacity when compared with weight change, BMI change, percentage of presurgery weight, and percentage of nadir weight (p<0.01 for all). Likewise, the %MWL exhibited the most accurate prediction, with an optimal cutoff point of 20 percent.