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Acta Diabetol. 2015 Oct;52(5):937-42. doi: 10.1007/s00592-015-0738-8. Epub 2015 Mar 27.

Clinical factors that predict remission of diabetes after different bariatric surgical procedures: interdisciplinary group of bariatric surgery of Verona (G.I.C.O.V.).

Author information

1
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, UOC Endocrinologia, University and University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy. mariagrazia.zenti@univr.it.
2
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, UOC Endocrinologia, University and University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy.
3
USD Clinical Psychology, Department of Medicine, University Hospital of Verona, Verona, Italy.
4
Division of Bariatric Surgery, Department of Surgery, University Hospital of Verona, Verona, Italy.

Abstract

AIMS:

The aims of the study were to investigate weight loss and glycemic control parameters after different bariatric surgical procedures in type 2 diabetes (T2D) obese patients and identify patients' factors that predict diabetes remission.

METHODS:

The study included 105 obese T2D patients (66 women and 39 men) who underwent laparoscopic gastric banding (LAGB, 11 subjects, age 47 ± 10 years, BMI 42.3 ± 8.3 kg/m(2)), or laparoscopic Roux-en-Y gastric bypass (RYBP, 77 subjects, age 50 ± 8 years, BMI 45.7 ± 6.8 kg/m(2)), or sleeve gastrectomy (SG, 17 subjects, age 49 ± 11 years, BMI 50.2 ± 8.8 kg/m(2)) during 2005-2012 period.

RESULTS:

The average percentage of weight loss at 12 months after surgery was 26.4 ± 9.8 %, and it was maintained at 24 and 36 months of follow-up. Diabetes remission occurred in 68.6 % of study participants (4/11 of LAGB, 54/77 of RYBP and 14/17 of SG). In multivariate Cox analysis, age, duration of diabetes, surgical procedure and glycated hemoglobin <53 mmol/mol (7 %) resulted significant predictors of diabetes remission (age RR = 0.97, 95 %CI 0.94-1.0, p = 0.05; diabetes duration RR = 0.93, 95 % CI 0.86-0.99, p = 0.036; rif LAGB, RYBP RR = 3.9, 95 % CI 1.31-11.57, p = 0.014; SG RR = 5.6, 95 % CI 1.67-18.64, p = 0.005; glycated hemoglobin RR = 0.54, 95 % CI 0.32-0.92, p = 0.024).

CONCLUSIONS:

Bariatric surgical procedures that modify the upper gastrointestinal tract anatomy (RYBP and SG) are more successful in producing weight loss and remission of T2D than those that simply restrict stomach capacity (LAGB). Younger age, short duration of diabetes and better glucose control confer higher probability of achieving remission of diabetes.

KEYWORDS:

Bariatric surgery; Diabetes; Diabetes remission; Obesity; Observational study

PMID:
25813367
DOI:
10.1007/s00592-015-0738-8
[Indexed for MEDLINE]

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