Obesity Surgery

, Volume 22, Issue 11, pp 1723–1729

Equivalent Weight Loss with Marked Metabolic Benefit Observed in a Matched Cohort with and Without Type 2 Diabetes 12 Months Following Gastric Bypass Surgery

  • Kathleen Yip
  • Leslie Heinberg
  • Victoria Giegerich
  • Philip R. Schauer
  • Sangeeta R. Kashyap
Clinical Research

DOI: 10.1007/s11695-012-0719-8

Cite this article as:
Yip, K., Heinberg, L., Giegerich, V. et al. OBES SURG (2012) 22: 1723. doi:10.1007/s11695-012-0719-8

Abstract

Background

Bariatric surgery results in dramatic weight loss and improves metabolic syndrome and type 2 diabetes (T2DM). However, previous studies have noted that morbidly obese patients with T2DM experience less weight loss benefits than non-diabetic patients following bariatric surgery. We sought to determine longitudinal effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) on percent excess body mass index (BMI) loss (%EBMIL) and clinical metabolic syndrome parameters in patients with T2DM compared with appropriately matched cohort without T2DM.

Methods

Retrospective cohort analysis of T2DM patients (n = 126) to non-T2DM patients (n = 126) matched on age (M = 48.1 ± 9.5), sex (81 % female), race (81 % Caucasian), and pre-surgical BMI (M = 49.3 ± 9.5). Lipids, glucose, hemoglobin A1c, blood pressure, co-morbidities of obesity, medications for co-morbidities, and T2DM medications were collected at baseline, 6 months and 12 months post-surgery. %EBMIL was collected at 1, 3, 6, 9, and 12 months post-surgery. One-way analyses of variance with effect sizes estimates were conducted to compare the two groups.

Results

As expected, T2DM subjects had significantly greater pre-surgical HbA1c, blood glucose, blood pressure, and lipid parameters at baseline vs. non-T2DM (all p values of<0.05). At 1, 3, 6, 9, and 12 months after LRYRB, both groups had similar reduction in %EBMIL (p > 0.10). At 6 months, there was a significant reduction in HbA1c, blood glucose, and lipid in the T2DM cohort compared with pre-surgical levels (p < 0.0001). At 12 months, these values were not different to that of the non-T2DM subjects (p > 0.10).

Conclusions

When matched on appropriate factors associated with weight loss outcomes, severely obese patients with T2DM have similar post-LRYGB weight loss outcomes in the first 12 months following surgery compared with non-T2DM patients. Furthermore, T2DM surgical patients achieved significant improvement in metabolic syndrome components.

Keywords

Type 2 diabetes mellitusMorbid obesityRoux-en-Y anastomosisWeight lossMetabolic syndromeGastric bypassBariatric surgeryInsulin

Abbreviations

BMI

Body mass index

FBG

Fasting blood glucose

HbA1c

Hemoglobin A1c

ICD-9

International Classification of Diseases ninth revision

LRYGB

Laparoscopic Roux-en-Y gastric bypass

LDL

Low-density lipoprotein

T2DM

Type 2 diabetes mellitus

VLDL

Very-low-density lipoprotein

Copyright information

© Springer Science + Business Media, LLC 2012

Authors and Affiliations

  • Kathleen Yip
    • 1
  • Leslie Heinberg
    • 1
    • 2
  • Victoria Giegerich
    • 2
  • Philip R. Schauer
    • 1
    • 2
  • Sangeeta R. Kashyap
    • 1
    • 3
  1. 1.Cleveland Clinic Lerner College of MedicineClevelandUSA
  2. 2.Bariatric and Metabolic InstituteCleveland ClinicClevelandUSA
  3. 3.Endocrinology, Diabetes and MetabolismCleveland ClinicClevelandUSA