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Obesity Surgery

, Volume 25, Issue 7, pp 1191–1197 | Cite as

Predictors of Remission of T2DM and Metabolic Effects after Laparoscopic Roux-en-y Gastric Bypass in Obese Indian Diabetics—a 5-Year Study

  • Aparna Govil Bhasker
  • Carlyne Remedios
  • Payal Batra
  • Amit Sood
  • Shehla Shaikh
  • Muffazal Lakdawala
Original Contributions

Abstract

Background

Bariatric surgery has proven results for diabetes remission in obese diabetics. Despite this, a lot of ambiguity exists around patient selection. The objectives of this study are the following: (1) evaluation of results of laparoscopic Roux-en-y gastric bypass (LRYGB) in obese type 2 diabetic (T2DM) Indian patients at 5 years and (2) to define predictors of success after surgery.

Methods

This is a prospective observational study. One hundred six Indian patients underwent LRYGB from January 2004 to July 2009. Patients were evaluated for percent excess weight loss (%EWL) and remission of T2DM. Mean age 50.34 ± 9.08 years, mean waist circumference 129.8 ± 20.8 cm, mean weight 119.2 ± 23.6 kg, mean BMI 45.01 ± 7.9 kg/m2, and mean duration of diabetes 8.2 ± 6.2 years.

Results

At 5 years, mean EWL% was 61.4 ± 20.3, mean weight regain of 8.6 ± 6.2 kg was seen in 63.6 %, mean glycosylated hemoglobin dropped from 8.7 ± 2.1 to 6.2 ± 01.3 %, mean triglycerides declined by 31 %, and serum high density lipoprotein rose by 18.4 %. Mean low-density lipoprotein levels declined by 6.8 %. Age, BMI, fasting C-peptide levels, duration of T2DM, and pre-op use of insulin emerged as significant predictors of success after surgery. One hundred percent remission was seen in patients with T2DM <5 years.

Conclusions

LRYGB is safe and efficacious for long-term remission of T2DM (BMI ≥ 35 kg/m2). In a country with the second largest population of type 2 diabetics in the world, predictors of success after surgery can help in prioritizing patients who have a greater chance to benefit from metabolic surgery.

Keywords

Laparoscopic Roux-en-Y gastric bypass Long-term results Type 2 diabetes mellitus Bariatric surgery Predictors of success 

Notes

Conflict of interest

The authors have no potential conflicts of interest of a financial or any other nature related to the topic of the manuscript.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Aparna Govil Bhasker
    • 1
    • 2
  • Carlyne Remedios
    • 1
  • Payal Batra
    • 1
    • 3
  • Amit Sood
    • 1
    • 2
  • Shehla Shaikh
    • 2
  • Muffazal Lakdawala
    • 1
    • 2
  1. 1.Center for Obesity and Digestive SurgeryMumbaiIndia
  2. 2.Institute of Minimally Invasive Surgical Sciences and Research CenterSaifee HospitalMumbaiIndia
  3. 3.Tufts UniversityBostonUSA

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