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Obesity Surgery

, Volume 21, Issue 7, pp 910–916 | Cite as

A Model for Predicting the Resolution of Type 2 Diabetes in Severely Obese Subjects Following Roux-en Y Gastric Bypass Surgery

  • Mark Thomas Hayes
  • Lynette Anne Hunt
  • Jonathan Foo
  • Yulia Tychinskaya
  • Richard Strawson Stubbs
Clinical Research

Abstract

Background

Severely obese type 2 diabetics who undergo Roux-en Y gastric bypass surgery have significant improvements in glycaemic control. Little work has been undertaken to establish the independent predictors of such resolution or to develop a predictive model. The aim of this study was to develop a mathematical model and establish independent predictors for the resolution of diabetes.

Methods

A consecutive sample of 130 severely obese type 2 diabetics who underwent gastric bypass surgery for weight loss from November 1997 to May 2007 with prospective pre-operative documentation of biochemical and clinical measurements was followed up over 12 months. Logistic discrimination analysis was undertaken to identify those variables with independent predictive value and to develop a predictive model for resolution of type 2 diabetes. Consecutive samples of 130 patients with body mass index (BMI) ≥ 35 with type 2 diabetes were selected. One hundred and twenty-seven patients completed the study with a sufficient data set. Patients were deemed unresolved if (1) diabetic medication was still required after surgery; (2) if fasting plasma glucose (FPG) remained >7 mmol/L; or (3) HbA1c remained >7%.

Results

Resolution of diabetes was seen in 84%, while diabetes remained but was improved in 16% of patients. Resolution was rapid and sustained with 74% of those on medication before surgery being able to discontinue this by the time of discharge 6 days following surgery. Five pre-operative variables were found to have independent predictive value for resolution of diabetes, including BMI, HbA1c, FPG, hypertension and requirement for insulin. Two models have been proposed for prediction of diabetes resolution, each with 86% correct classification in this cohort of patients.

Conclusions

Type 2 diabetes resolves in a very high percentage of patients undergoing gastric bypass surgery for severe obesity. The key predictive variables include pre-operative BMI, HbA1c, FPG, the presence of hypertension and diabetic status.

Keywords

Mathematical model Diabetes resolution Gastric bypass surgery 

Notes

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Mark Thomas Hayes
    • 2
  • Lynette Anne Hunt
    • 3
  • Jonathan Foo
    • 1
    • 2
  • Yulia Tychinskaya
    • 1
  • Richard Strawson Stubbs
    • 1
    • 2
  1. 1.The Wakefield ClinicWellingtonNew Zealand
  2. 2.Wakefield Biomedical Research UnitUniversity of OtagoWellingtonNew Zealand
  3. 3.Department of StatisticsUniversity of WaikatoHamiltonNew Zealand

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