Impact of Abdominal Subcutaneous Fat Reduction on Glycemic Control in Obese Patients with Type 2 Diabetes Mellitus

Background: The effect on type 2 diabetes mellitus (T2DM) when adipose tissue is removed is controversial. This study aimed to evaluate and compare the effect of the abdominoplasty and bariatric surgery on glycemic control in patients with T2DM. Methods: Patients with T2DM undergoing abdominoplasty for cosmesis were studied (n = 25). Subjects were 36.9 ± 1.3 years with a preoperative body mass index (BMI) of 40.6 ± 0.5 kg/m2 and mean glycated hemoglobin (HbA1c) of 7.4% ± 0.2%. Fifteen matched patients undergoing bariatric surgery were selected as a comparator group. Weight, BMI, waist circumference (WC), random blood glucose (RBG), and HbA1c were evaluated at baseline and 3, 6, and 12 months postsurgery. Results: By 12 months, abdominoplasty reduced weight by 5.6 ± 0.3 kg p < 0.01), and HbA1c was reduced to 6.8% ± 0.3% (p < 0.01). After 12 months, bariatric surgery reduced BMI from 42.2 ± 1 kg/m2 to 26.6 ± 0.4 kg/m2 (p < 0.01). HbA1c reduced from 7.9% ± 0.4% to 5.5% ± 0.2% (p < 0.01). WC was similar between both groups at 3 months, although HbA1c reductions were superior after bariatric surgery. Conclusions: Reducing subcutaneous adipose tissue with abdominoplasty results in a small improvement in glycemic control in patients with T2DM. Despite equivalent WC at 3 months, bariatric surgery outperformed abdominoplasty on all metabolic parameters then and thereafter.