Clinical factors that predict remission of diabetes after different bariatric surgical procedures: interdisciplinary group of bariatric surgery of Verona (G.I.C.O.V.)
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The aims of the study were to investigate weight loss and glycemic control parameters after different bariatric surgical procedures in type 2 diabetes (T2D) obese patients and identify patients’ factors that predict diabetes remission.
The study included 105 obese T2D patients (66 women and 39 men) who underwent laparoscopic gastric banding (LAGB, 11 subjects, age 47 ± 10 years, BMI 42.3 ± 8.3 kg/m2), or laparoscopic Roux-en-Y gastric bypass (RYBP, 77 subjects, age 50 ± 8 years, BMI 45.7 ± 6.8 kg/m2), or sleeve gastrectomy (SG, 17 subjects, age 49 ± 11 years, BMI 50.2 ± 8.8 kg/m2) during 2005–2012 period.
The average percentage of weight loss at 12 months after surgery was 26.4 ± 9.8 %, and it was maintained at 24 and 36 months of follow-up. Diabetes remission occurred in 68.6 % of study participants (4/11 of LAGB, 54/77 of RYBP and 14/17 of SG). In multivariate Cox analysis, age, duration of diabetes, surgical procedure and glycated hemoglobin <53 mmol/mol (7 %) resulted significant predictors of diabetes remission (age RR = 0.97, 95 %CI 0.94–1.0, p = 0.05; diabetes duration RR = 0.93, 95 % CI 0.86–0.99, p = 0.036; rif LAGB, RYBP RR = 3.9, 95 % CI 1.31–11.57, p = 0.014; SG RR = 5.6, 95 % CI 1.67–18.64, p = 0.005; glycated hemoglobin RR = 0.54, 95 % CI 0.32–0.92, p = 0.024).
Bariatric surgical procedures that modify the upper gastrointestinal tract anatomy (RYBP and SG) are more successful in producing weight loss and remission of T2D than those that simply restrict stomach capacity (LAGB). Younger age, short duration of diabetes and better glucose control confer higher probability of achieving remission of diabetes.
KeywordsDiabetes remission Diabetes Bariatric surgery Obesity Observational study
Conflict of interest
The authors declare that they have no conflict of interest.
The study has been reviewed by the Ethic Committee of the University of Verona, and has been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.
Informed consent was obtained from all patients for being included in the study.
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