Predictors of Short-Term Diabetes Remission After Laparoscopic Roux-en-Y Gastric Bypass

Gianluca Iacobellis, Chengyu Xu, Rafael E Campo, Nestor de la Cruz-Munoz

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: A remission of type 2 diabetes mellitus (T2DM) is one of the major goals of the contemporary bariatric surgery. The goal of our study is to identify predictors of short-term postoperative diabetes remission in order to facilitate preoperative patient selectionMaterials and Methods: Two hundred forty-five obese (body mass index (BMI) ≥35 kg/m2) T2DM subjects who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were followed up to 1 year after bariatric surgery. Diabetes remission was defined as hemoglobin A1c (HbA1c) ≤6 % and fasting blood glucose (FBG) <100 mg/dl in absence of all diabetic medications.Results: Twenty-six percent of the patients seen in f/u achieved complete remission at 1 year. Average Hba1c decreased from 8 to 6.7 % and 6.4 % after 6 and 12 months, respectively. Regression analysis showed that age (p = 0.01), number of diabetes complications (p = 0.03), family history of diabetes (p = 0.04), preoperative use of insulin (p = 0.04), and peri- and postoperative weight loss (p = 0.05, for both) were the best preoperative predictors of diabetes remission at 6 and 12 months (R<sup>2</sup> = 0.3).Conclusion: Younger patients, with fewer diabetic complications, no family history of diabetes, not using insulin, and with greater peri- and postoperative weight loss were the best candidates to achieve a rapid diabetes remission after RYGB.

Original languageEnglish (US)
Pages (from-to)782-787
Number of pages6
JournalObesity Surgery
Volume25
Issue number5
DOIs
StatePublished - May 1 2015

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Bariatric Surgery
Gastric Bypass
Type 2 Diabetes Mellitus
Diabetes Complications
Blood Glucose
Weight Loss
Fasting
Hemoglobins
Body Mass Index
Insulin

Keywords

  • Diabetes remission
  • Obesity
  • RYGB
  • Type 2 diabetes mellitus

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

Predictors of Short-Term Diabetes Remission After Laparoscopic Roux-en-Y Gastric Bypass. / Iacobellis, Gianluca; Xu, Chengyu; Campo, Rafael E; de la Cruz-Munoz, Nestor.

In: Obesity Surgery, Vol. 25, No. 5, 01.05.2015, p. 782-787.

Research output: Contribution to journalArticle

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N2 - Purpose: A remission of type 2 diabetes mellitus (T2DM) is one of the major goals of the contemporary bariatric surgery. The goal of our study is to identify predictors of short-term postoperative diabetes remission in order to facilitate preoperative patient selectionMaterials and Methods: Two hundred forty-five obese (body mass index (BMI) ≥35 kg/m2) T2DM subjects who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were followed up to 1 year after bariatric surgery. Diabetes remission was defined as hemoglobin A1c (HbA1c) ≤6 % and fasting blood glucose (FBG) <100 mg/dl in absence of all diabetic medications.Results: Twenty-six percent of the patients seen in f/u achieved complete remission at 1 year. Average Hba1c decreased from 8 to 6.7 % and 6.4 % after 6 and 12 months, respectively. Regression analysis showed that age (p = 0.01), number of diabetes complications (p = 0.03), family history of diabetes (p = 0.04), preoperative use of insulin (p = 0.04), and peri- and postoperative weight loss (p = 0.05, for both) were the best preoperative predictors of diabetes remission at 6 and 12 months (R2 = 0.3).Conclusion: Younger patients, with fewer diabetic complications, no family history of diabetes, not using insulin, and with greater peri- and postoperative weight loss were the best candidates to achieve a rapid diabetes remission after RYGB.

AB - Purpose: A remission of type 2 diabetes mellitus (T2DM) is one of the major goals of the contemporary bariatric surgery. The goal of our study is to identify predictors of short-term postoperative diabetes remission in order to facilitate preoperative patient selectionMaterials and Methods: Two hundred forty-five obese (body mass index (BMI) ≥35 kg/m2) T2DM subjects who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were followed up to 1 year after bariatric surgery. Diabetes remission was defined as hemoglobin A1c (HbA1c) ≤6 % and fasting blood glucose (FBG) <100 mg/dl in absence of all diabetic medications.Results: Twenty-six percent of the patients seen in f/u achieved complete remission at 1 year. Average Hba1c decreased from 8 to 6.7 % and 6.4 % after 6 and 12 months, respectively. Regression analysis showed that age (p = 0.01), number of diabetes complications (p = 0.03), family history of diabetes (p = 0.04), preoperative use of insulin (p = 0.04), and peri- and postoperative weight loss (p = 0.05, for both) were the best preoperative predictors of diabetes remission at 6 and 12 months (R2 = 0.3).Conclusion: Younger patients, with fewer diabetic complications, no family history of diabetes, not using insulin, and with greater peri- and postoperative weight loss were the best candidates to achieve a rapid diabetes remission after RYGB.

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