Obesity Surgery

, Volume 25, Issue 1, pp 1–6

Predicting Remission of Diabetes After RYGB Surgery Following Intensive Management to Optimize Preoperative Glucose Control

  • Thomas MacAndrew English
  • Samir Malkani
  • Rebecca L. Kinney
  • Abdulkadir Omer
  • Mary Beth Dziewietin
  • Richard Perugini
Original Contributions

Abstract

Background

The purpose of the study is to investigate the association of preoperative glucose optimization prior to a Roux-en-Y gastric bypass (RYGB) and diabetes remission.

Methods

The study is a retrospective review of 245 patients with a history of diabetes type II and a RYGB from 2008 to 2012 at UMass Memorial Hospital.

Results

Patients that benefited from glucose optimization prior to RYGB were more likely to achieve diabetes remission 1 year after surgery. The preoperative glucose optimization intervention demonstrated that when patients decreased their HbA1c prior to surgery by 1 %, these individuals were 68 % more likely to remit (p = 0.015). Duration of diabetes (p = 0.005) and insulin use (p < 0.001) were also significant predictors of remission, whereas age, race, and gender were not.

Conclusions

Our study results indicate that a greater degree of glycemic improvement in response to presurgical medical intervention is associated with higher rates of diabetes remission post-operatively among obese adults with diabetes type II. Conversely, the lack of favorable glycemic response to intensification of medical management predicts a poor glycemic response to bariatric surgery. Further research is needed to determine if this difference is due to physiological factors or is simply an indicator of patient behavior.

Keywords

Diabetes Gastric bypass Remission Glucose optimization Medical intervention 

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Thomas MacAndrew English
    • 1
  • Samir Malkani
    • 2
  • Rebecca L. Kinney
    • 1
  • Abdulkadir Omer
    • 3
  • Mary Beth Dziewietin
    • 1
  • Richard Perugini
    • 4
  1. 1.Department of Quantitative Health SciencesUniversity of Massachusetts Medical SchoolWorcesterUSA
  2. 2.Diabetes Center of ExcellenceUniversity of Massachusetts Medical SchoolWorcesterUSA
  3. 3.EndocrinologyUniversity of Massachusetts Medical SchoolWorcesterUSA
  4. 4.Department of SurgeryUniversity of Massachusetts Medical SchoolWorcesterUSA

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