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Obes Surg. 2016 Apr;26(4):749-56. doi: 10.1007/s11695-015-1823-3.

Prediction of Diabetes Remission in Morbidly Obese Patients After Roux-en-Y Gastric Bypass.

Author information

1
Department of Surgery, Seoul Hospital, Soonchunhyang University, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Republic of Korea.
2
Department of Surgery, National Cancer Center, Goyang-si, Republic of Korea.
3
Department of Surgery, Seoul Hospital, Soonchunhyang University, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Republic of Korea. yjgs1997@gmail.com.

Abstract

BACKGROUND:

Morbidly obese patients with type 2 diabetes have shown significant improvement in glycemic control after Roux-en-Y gastric bypass (RYGB). This study aimed to elucidate the predictors of diabetes remission.

METHODS:

A retrospective review of a prospectively established database identified 134 type 2 diabetes patients who underwent laparoscopic RYGB between January 2011 and February 2014. Partial and complete remission of diabetes was defined as glycated hemoglobin (HbA1c) level <6.5 and <6.0%, respectively, without the use of antidiabetic medication. Pre- and postoperative clinical outcomes were compared between the remission and non-remission groups to identify the predictors of partial or complete remission of diabetes.

RESULTS:

The mean duration of diabetes and preoperative HbA1c level were 4.6 years and 8.0%, respectively. The body mass index (BMI) of the enrolled patients decreased from 37.9 to 28.8 kg/m(2) during the mean follow-up of 12.3 months; 61.8% of the patients achieved partial or complete remission of diabetes. Multivariate analysis revealed that age at operation (odds ratio [OR] = 0.880; 95% confidence interval [CI] 0.807-0.960), HbA1c level (OR = 0.527; 95% CI 0.325-0.854), and C-peptide level (OR = 1.463; 95% CI 1.054-2.029) in the preoperative laboratory study, and the percentage of total weight loss (%TWL) (OR = 1.186; 95% CI 1.072-1.313) after RYGB were the independent predictors of partial or complete diabetes remission.

CONCLUSION:

The predictive factors for diabetes remission after RYGB include age at operation, HbA1c and C-peptide levels, and the %TWL after surgery.

KEYWORDS:

Diabetes remission; Morbid obesity; Roux-en-Y gastric bypass; Type 2 diabetes

PMID:
26205218
DOI:
10.1007/s11695-015-1823-3
[Indexed for MEDLINE]

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