Prediction of Diabetes Remission in Morbidly Obese Patients After Roux-en-Y Gastric Bypass
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Morbidly obese patients with type 2 diabetes have shown significant improvement in glycemic control after Roux-en-Y gastric bypass (RYGB). This study aimed to elucidate the predictors of diabetes remission.
A retrospective review of a prospectively established database identified 134 type 2 diabetes patients who underwent laparoscopic RYGB between January 2011 and February 2014. Partial and complete remission of diabetes was defined as glycated hemoglobin (HbA1c) level <6.5 and <6.0 %, respectively, without the use of antidiabetic medication. Pre- and postoperative clinical outcomes were compared between the remission and non-remission groups to identify the predictors of partial or complete remission of diabetes.
The mean duration of diabetes and preoperative HbA1c level were 4.6 years and 8.0 %, respectively. The body mass index (BMI) of the enrolled patients decreased from 37.9 to 28.8 kg/m2 during the mean follow-up of 12.3 months; 61.8 % of the patients achieved partial or complete remission of diabetes. Multivariate analysis revealed that age at operation (odds ratio [OR] = 0.880; 95 % confidence interval [CI] 0.807–0.960), HbA1c level (OR = 0.527; 95 % CI 0.325–0.854), and C-peptide level (OR = 1.463; 95 % CI 1.054–2.029) in the preoperative laboratory study, and the percentage of total weight loss (%TWL) (OR = 1.186; 95 % CI 1.072–1.313) after RYGB were the independent predictors of partial or complete diabetes remission.
The predictive factors for diabetes remission after RYGB include age at operation, HbA1c and C-peptide levels, and the %TWL after surgery.
KeywordsMorbid obesity Roux-en-Y gastric bypass Type 2 diabetes Diabetes remission
Min Ju Soh and Suyeon Park contributed to this study as a research coordinator and a statistician, respectively. This research was supported by the Soonchunhyang University Research Fund.
Conflict of Interest
The authors declare that they have no competing interests.
The need for patient informed consent for this retrospective study was waived by the institutional review board.
This study was approved by the institutional ethics committee of Soonchunhyang University Seoul Hospital and has been performed in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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