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Bariatric surgery outperforms abdominoplasty for glycemic control in type 2 diabetes
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Adults with type 2 diabetes who underwent abdominoplasty to reduce subcutaneous adipose tissue experienced small improvements in glycemic control, but those who underwent bariatric surgery were more likely to experience greater improvements in glycemic control and weight loss, according to researchers in Egypt.
Mahmoud Abdelaal, MB, ChB, MSc, of the plastic surgery department at Assiut University Hospital in Egypt, and colleagues evaluated adults with type 2 diabetes who underwent abdominoplasty (n = 25; mean age, 36.9 years; mean BMI, 40.6 kg/m2; mean HbA1c, 7.4%; 100% women) or bariatric surgery (n = 15; mean age, 35.8 years; mean BMI, 42.2 kg/m2; mean HbA1c, 7.9%; 93% women; mini-gastric bypass, n = 10; vertical sleeve gastrectomy, n = 5) to determine the effect of each on glycemic control. Participants’ weight, BMI, waist circumference, random blood glucose level and HbA1c were all evaluated at baseline and 3, 6 and 12 months after surgery.
In the abdominoplasty group, weight decreased from 105.8 kg at baseline to 99.9 kg at 12 months (P < .01), BMI decreased from 40.6 kg/m2 to 38.5 kg/m2 (P < .01) and waist circumference decreased from 115.8 cm to 100.8 cm (P < .01). In the bariatric surgery group, weight decreased from 111.1 kg at baseline to 70.5 kg at 12 months (P < .001), BMI decreased from 42.2 kg/m2 to 26.6 kg/m2 (P < .001) and waist circumference decreased from 118.9 cm to 91.9 cm (P < .001). The bariatric surgery group compared with the abdominoplasty group experienced greater reductions in BMI and weight at 3, 6 and 12 months of follow-up and greater reductions in waist circumference at 6 and 12 months of follow-up (P < .01).
In the abdominoplasty group, HbA1c decreased from 7.4% at baseline to 6.8% at 12 months, and random blood glucose decreased from 262.2 mg/dL to 237.6 mg/dL (P < .01 for both). In the bariatric surgery group, HbA1c decreased from 7.9% at baseline to 5.5% at 12 months (P < .01), and random blood glucose decreased from 289.6 mg/dL to 171.1 mg/dL (P < .01). The bariatric surgery group experienced greater reductions in HbA1c and random blood glucose compared with the abdominoplasty group (P < .01).
“This may provide future insight into the likely proportional impact of deep subcutaneous adipose tissue loss on glycemic control,” the researchers wrote. “The small improvement observed after abdominoplasty lends support to the idea that deep subcutaneous adipose tissue removal may reduce insulin resistance, although only having a small impact on glycemic control on patients with [type 2 diabetes].” – by Amber Cox
Disclosures: The authors report no relevant financial disclosures.
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