A recent study from the University of Utah Health has found that blood fat levels can predict diabetes remission after gastric bypass surgery. The study measured blood levels of ceramides to evaluate the likelihood of diabetes remission after gastric bypass surgery. From this study, it was concluded that high levels of ceramide made it harder to achieve diabetes remission, regardless of weight loss results. 

Defining Diabetes Remission after Gastric Bypass Surgery 

The rate of diabetes remission in post-bariatric patients varies greatly based on how remission is defined. One study suggests a 93% remission rate, while another study that follows a more strict definition cites a 44% remission rate. The most commonly used definition for remission is defined as "achieving glycemia below the diabetes range in the absence of active pharmacological or surgical therapy." 

Partial remission is determined when hyperglycemia (HbA1c) was below 6.5% and fasting glucose was between 100 and 125 mg/dL for at least one year. Total remission is defined as completely normal glucose metabolic levels with HbA1c and fasting glucose less than 100 mg/dL for one year. 

However, most studies still review remission as an HbA1c measurement at a single point in time instead of across a prolonged time period. This measurement can be biased and lead to inflated results. From the study performed at the University of Utah Health, 73% of post-gastric bypass patients had a temporary or sustained remission of their type 2 diabetes. 

The Role of Ceramides in Diabetics 

Ceramides are waxy lipid molecules comprised of fatty acids and found within cell membranes. Ceramides play an important role in coordinating cellular responses to extracellular stimuli. They are products of metabolism and can accumulate in obese individuals leading to tissue dysfunction. Ceramides limit the amount of insulin the body can produce or use, which can lead to diabetes. 

The main hypothesis that explains the role of ceramides in diabetics is due to the link to insulin resistance. Ceramides combine saturated fatty acids and inflammatory cytokines that can lead to the progression of insulin resistance. As ceramide levels rise, so does the risk of developing diabetes, hypertension, cardiac failure, or atherosclerosis. 

How Ceramide Levels Can Predict Diabetes Remission

In the study conducted at the University of Utah Health, nearly 1,200 blood samples were analyzed. Of that group, 36% had gastric bypass surgery, 36% wanted surgery but were denied due to insurance, and 28% were obese but not considering gastric bypass surgery. 

It was discovered that diabetic patients who had low ceramide levels before gastric bypass surgery saw greater diabetes remission rates. On the contrary, individuals who had high ceramide levels did not attain diabetes remission, regardless of their weight loss results. 

The scientists in this study believe that measuring ceramide levels in pre-bariatric surgery patients could help determine the rate of diabetes remission post-operatively. However, more research will need to be conducted in order to recommend blood fat testing in bariatric clinics. The next step for the researchers includes analyzing the link between ceramide levels and diabetes progression in non-bariatric populations to solidify their determinations from this study.