Abstract
The frequency of prediabetes as well as the optimal method to identify glucose abnormalities in morbid obesity (MO) is subject to debate. We, therefore, evaluated the frequency of prediabetes and the optimal method for its respective diagnosis in a large cohort with MO. We included 1.626 patients with MO (age 34±10 years, BMI 44.6± 7.0 kg/m², 74.3% women). All patients without overt type 2 diabetes (T2D) underwent a 75g OGTT. Prediabetes was diagnosed according to ADA criteria. Demographic, cardiovascular risk-markers, insulin levels and renal parameters were assessed. We excluded 421 (25.9%) patients due to T2D. Regarding prediabetes, 339 patients (28.1%) fulfilled the fasting glucose criterion, 240 the 2-hour postprandial criterion (19.9%), and 594 patients the HbA1c criterion (49.2%). 56 patients (4.6%) fulfilled all three criteria, 810 (67.2%) had at least one criterion. 933 (77.4%) patients fulfilled either the fasting glucose or the HbA1c criterion, and 834 (69.2%) either the 2h postprandial or HbA1c criterion. Patient's characteristics are depicted in table 1. The results of our study suggest that fasting glucose or HbA1c are sufficient to diagnose prediabetes. This is particularly of interest since postoperative changes in gut anatomy following bariatric surgery might render a postoperative OGTT invalid for follow-up, whereas fasting glucose or HbA1c are not affected. Disclosure J.Brix: Advisory Panel; Boehringer Ingelheim Pharma GmbH&Co.KG, Eli Lilly and Company, Novo Nordisk, Speaker's Bureau; AstraZeneca, Eli Lilly and Company, Novo Nordisk. V.Parzer: None. S.L.Huber: None. B.Ludvik: Advisory Panel; Eli Lilly and Company, Novo Nordisk, Boehringer Ingelheim Pharma GmbH&Co.KG, Amgen Inc., AstraZeneca, Research Support; Eli Lilly and Company, Novo Nordisk, Boehringer Ingelheim Pharma GmbH&Co.KG, Amgen Inc., AstraZeneca, Speaker's Bureau; Eli Lilly and Company, Novo Nordisk, Boehringer Ingelheim Pharma GmbH&Co.KG, Amgen Inc., AstraZeneca.
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