In a nutshell
This study examined if the levels of succinate in the blood could indicate remission of Type 2 diabetes (T2D) in patients that had bariatric surgery. The authors found that succinate levels were lower in patients who achieved remission of T2D after surgery.
Some background
One of the main goals of treatment for T2D is to lower blood glucose levels. Some patients with T2D have other conditions, such as heart disease and obesity. Treating obesity can help lower blood glucose levels to healthy levels. Having normal blood glucose levels without anti-diabetes therapy is called T2D remission.
Bariatric surgery is an effective treatment for obesity. This procedure reduces the size of the stomach and can help improve T2D symptoms. Several factors that may indicate T2D remission after bariatric surgery. One factor that is currently under investigation is succinate. Succinate is a molecule found in the blood that is made during metabolism. Whether succinate levels indicate T2D remission in patients after bariatric surgery remains unclear.
Methods & findings
This study had 45 patients with T2D and who were obese. Patients were divided into three groups (15 patients each). Patients had either Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), or laparoscopic greater curvature plication (LGCP) surgery. The levels of succinate and glucose in the blood were measured before surgery, one year after surgery, and two years after surgery.
Overall, 51.1% of all patients achieved T2D remission one year later. Patients who underwent RYGB had the highest level of remission (26.7%), followed by SG (17.8%) and LGCP (6.7%). After two years, 46.7% of all patients were still in remission. 24.4% of patients who had RYGB were still in remission two years later.
Before surgery, succinate levels in the blood were not significantly different between all three groups. However, one year after surgery, succinate levels significantly dropped from 58.9 µmol/L to 46 µmol/L. Only patients in the RYGB group had the most significant decrease, from 58.1 µmol/L to 38.6 µmol/L.
In a separate analysis, significantly more patients with succinate levels below 48.1 µmol/L before surgery achieved remission compared to patients with levels above 48.1 µmol/L (85.7% vs. 35.5%).
The bottom line
This study concluded that succinate levels in the blood might indicate diabetes remission in patients with T2D. The authors suggest that 48.1 µmol/L may be used as the cut-off point for remission.
The fine print
This study had a small number of patients. Also, only a few samples were collected from each patient. More studies are needed to confirm these results.
What’s next?
Talk to your doctor about the potential benefits of bariatric surgery.
Published By :
Diabetes Care
Date :
Aug 02, 2019
