A total of 13 morbidly obese patients (7 BPD, 6 LAGB) underwent serial measurements of fasting glucose and insulin at baseline, immediately after surgery (days 1-7), and 1, 6, and 12 months postoperatively. The homeostasis model of assessment-insulin resistance was calculated.
In the BPD group, the glucose levels had normalized by day 3 (5.6 ¡À 1 mmol/L) and the difference was statistically significant at 6 and 12 months postoperatively (5 ¡À .7 and 4.4 ¡À .5 mmol/L, respectively). The insulin levels had improved from day 1, and the difference was statistically significant at days 2, 5, 6, and 7 (19 ¡À 9, 14.2 ¡À 7, 15.2 ¡À 8, and 17.4 ¡À 8 mU/L, respectively). All diabetes medications were stopped on the fourth postoperative day. In the LAGB group, no statistically significant changes were seen in the glucose levels. Statistically significant changes in insulin were seen on days 1 and 2 (19 ¡À 13 and 13 ¡À 6.5 mU/L, respectively). The homeostatic model of assessment-insulin resistance had improved in both groups (BPD, 1.6 ¡À 1.2, P < .01; and LAGB, 4.3 ¡À 1.4, P < .05).
BPD causes immediate remission of type 2 diabetes mellitus. Leptin might play an important role in the early improvement of insulin resistance in fasting states after BPD. In the LAGB group, glucose homeostasis improved, but the patients still required diabetes medications, although the dosages were reduced.