2318-PUB: Indices Using Basal Glucose and Insulin Values Are Comparable to Dynamic Values in Assessing Changes in Glucose Metabolism following Bariatric Surgery (BS)

Abstract

Introduction: Improvement of insulin resistance (IR) as contributor of diabetes remission and prevention is a beneficial effect of BS. We investigated the ability of indices using either basal or stimulated glucose/insulin values to assess changes in IR and insulin sensitivity (IS) in morbid obese (MO) patients. Methods: We included 339 patients: 27 with diabetes mellitus (DM, age 44±12 yrs, BMI 49±10kg/m²), 91 with impaired fasting glucose or impaired glucose tolerance (IFG/IGT), (age 41±11 yrs, BMI 47± 7kg/m²) and 221 with normal glucose tolerance (NGT, age 38±10 yrs, BMI 46± 7kg/m²). All patients underwent a 75g OGTT, glucose and insulin levels were repeatedly measured. IR and IS indices were calculated. Results: Remission to NGT occurred in 70.4% of DM and in 97.8% of IFG/IGT. Basal and stimulated indices were equally able to demonstrate changes of glucose metabolism (table1). Before BS, IR was higher in DM for all indices (p<0.001). After BS, there were no differences in AUC glucose (p=0.454), HOMA (p=0.905) and Matsuda (p=0.469) but IFG/IGT patients had a higher AUC insulin (p=0.024) and a lower IGI (p=0.024) compared to DM. Conclusion: Indices using basal values are equally able to assess changes in glucose metabolism compared to stimulated indices. They represent a tool for simple and valid determination of glucose metabolism in this cohort. Disclosure J. Brix: None. A. Tura: None. B. Ludvik: Advisory Panel; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Novo Nordisk A/S, Sanofi. Research Support; Self; Bayer Healthcare Pharmaceuticals Inc., Eli Lilly and Company, Merck & Co., Inc., Novartis Pharmaceuticals Corporation. Speaker’s Bureau; Self; Amgen.