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Predictors of Short-Term Diabetes Remission After Laparoscopic Roux-en-Y Gastric Bypass

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Abstract

Purpose

A remission of type 2 diabetes mellitus (T2DM) is one of the major goals of the contemporary bariatric surgery. The goal of our study is to identify predictors of short-term postoperative diabetes remission in order to facilitate preoperative patient selection.

Materials and Methods

Two hundred forty-five obese (body mass index (BMI) ≥35 kg/m2) T2DM subjects who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were followed up to 1 year after bariatric surgery. Diabetes remission was defined as hemoglobin A1c (HbA1c) ≤6 % and fasting blood glucose (FBG) <100 mg/dl in absence of all diabetic medications.

Results

Twenty-six percent of the patients seen in f/u achieved complete remission at 1 year. Average Hba1c decreased from 8 to 6.7 % and 6.4 % after 6 and 12 months, respectively. Regression analysis showed that age (p = 0.01), number of diabetes complications (p = 0.03), family history of diabetes (p = 0.04), preoperative use of insulin (p = 0.04), and peri- and postoperative weight loss (p = 0.05, for both) were the best preoperative predictors of diabetes remission at 6 and 12 months (R 2 = 0.3).

Conclusion

Younger patients, with fewer diabetic complications, no family history of diabetes, not using insulin, and with greater peri- and postoperative weight loss were the best candidates to achieve a rapid diabetes remission after RYGB.

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Acknowledgments

The authors want to thank Drs. Daisy Acevedo, Melany Castillo, Jose Llinas, Elizabeth McAninch, Alex Manzano, Ngina Muigai, Lara Mikel Paraskos, and Andreina Rojas for their invaluable contribution to this study.

Conflict of Interest

The authors declare that there are no conflicts of interest.

Statement of Informed Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

This study has been approved by the Institutional Review Board (IRB) of the University of the Miami (IRB No.: MOD00000856) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Authors and Affiliations

  1. Division of Diabetes, Endocrinology and Metabolism, University of Miami, 1400 NW 10th Ave, Dominion Tower suite 805-807, Miami, FL, 33136, USA

    Gianluca Iacobellis & Chengyu Xu

  2. Division of Infectious Diseases, Department of Medicine, Miami, FL, USA

    Rafael E. Campo

  3. Division of Laparoendoscopic and Bariatric Surgery, Department of Surgery, University of Miami Hospital, Miami, FL, USA

    Nestor F. De La Cruz-Munoz

  4. University of Miami, Miller School of Medicine, Miami, FL, USA

    Gianluca Iacobellis, Chengyu Xu, Rafael E. Campo & Nestor F. De La Cruz-Munoz

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  1. Gianluca Iacobellis
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  2. Chengyu Xu
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  3. Rafael E. Campo
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  4. Nestor F. De La Cruz-Munoz
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Correspondence to Gianluca Iacobellis.

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Iacobellis, G., Xu, C., Campo, R.E. et al. Predictors of Short-Term Diabetes Remission After Laparoscopic Roux-en-Y Gastric Bypass. OBES SURG 25, 782–787 (2015). https://doi.org/10.1007/s11695-014-1477-6

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  • DOI: https://doi.org/10.1007/s11695-014-1477-6

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