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

Objective: To evaluate diabetes remission after bariatric surgery by presence of glutamic acid decarboxylase (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. 9/16 patients with GAD and 112/205 without GAD proceeded with surgery. Diabetes remission and weight loss was compared by GAD presence.

Results: GAD titres were 16-91 IU/mL in the first group. Both groups were similar in age, BMI, diabetes duration, insulin treated proportion, HbA1c and C-peptide (1354 ± 548 vs 1358 ± 487pmol/L). At 1 and 5 years post-operatively, both groups achieved similar BMI reduction and diabetes remission (67% vs 73%, p=0.71, and 56% vs 57%, p=1.0).

Conclusion: Low-titre GAD in patients with T2D and retained C-peptide, should not be a deterrent for bariatric surgery when the principal aim is diabetes remission.