Adults with long-duration type 2 diabetes have blunted glycemic and β-cell function improvements after bariatric surgery

Obesity (Silver Spring). 2015 Mar;23(3):523-6. doi: 10.1002/oby.21021. Epub 2015 Feb 3.


Objective: This study investigated the effect of type 2 diabetes duration on glucose regulation 24 months post-bariatric surgery.

Methods: Twenty-seven adults with short- (<5 years) and long-duration (≥10 years) type 2 diabetes received a mixed-meal tolerance test at baseline and 24 months postsurgery. Body weight, insulin sensitivity, first- and second-phase meal-stimulated insulin secretion, disposition index (i.e., DI or pancreatic β-cell function), and incretin responses were examined.

Results: Adults with short-duration type 2 diabetes had better HbA(1c), greater insulin secretory capacity, and greater DI compared with adults with long-duration type 2 diabetes, despite similar weight loss and incretin responses. Diabetes duration correlated with smaller improvements in HbA(1c) and DI but not weight loss.

Conclusions: Enhanced β-cell function characterizes the effect of bariatric surgery in adults with diabetes for <5 years, independent of weight loss or incretins. Additional therapy postsurgery may be required to improve glycemia for people with long-standing type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bariatric Surgery
  • Body Mass Index
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Diabetes Mellitus, Type 2 / surgery
  • Female
  • Glycemic Index
  • Humans
  • Incretins / metabolism
  • Insulin / metabolism
  • Insulin Secretion
  • Insulin-Secreting Cells / physiology
  • Male
  • Middle Aged
  • Postoperative Period
  • Prospective Studies


  • Incretins
  • Insulin