Good Glycemic Outcomes Following Bariatric Surgery Among Patients With Type 2 Diabetes, Obesity, and Low-Titer GAD Antibodies

Abstract

OBJECTIVE To evaluate diabetes remission after bariatric surgery by presence of GAD antibody among those with obesity and type 2 diabetes (T2D). RESEARCH DESIGN AND METHODS Screening GAD was performed in 221 patients with T2D and obesity referred for bariatric surgery. Nine of 16 patients with GAD and 112 of 205 without GAD proceeded with surgery. Diabetes remission and weight loss were compared by GAD presence. RESULTS The group with GAD had levels 16–91 IU/mL. Those with and without GAD were similar with regard to age, BMI, diabetes duration, proportion treated with insulin, HbA1c, and C-peptide (1,354 ± 548 vs. 1,358 ± 487 pmol/L). At 1 and 5 years postoperatively, the two groups achieved similar BMI reduction and diabetes remission (67% vs. 73%, P = 0.71, and 56% vs. 57%, P = 1.0). CONCLUSIONS Low-titer GAD in patients with T2D and retained C-peptide should not be a deterrent for bariatric surgery when the principal aim is diabetes remission.