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

被引:12
作者
Iacobellis, Gianluca [1 ,4 ]
Xu, Chengyu [1 ,4 ]
Campo, Rafael E. [2 ,4 ]
De La Cruz-Munoz, Nestor F. [3 ,4 ]
机构
[1] Univ Miami, Div Diabet Endocrinol & Metab, Miami, FL 33136 USA
[2] Dept Med, Div Infect Dis, Miami, FL USA
[3] Univ Miami Hosp, Dept Surg, Div Laparoendoscop & Bariatr Surg, Miami, FL USA
[4] Univ Miami, Miller Sch Med, Miami, FL 33136 USA
关键词
RYGB; Type 2 diabetes mellitus; Obesity; Diabetes remission; BARIATRIC SURGERY; WEIGHT-LOSS; MEDICAL THERAPY; RISK-FACTORS; MELLITUS; OBESITY; PREVALENCE; PATIENT; IMPACT; ADULTS;
D O I
10.1007/s11695-014-1477-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
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. Two hundred forty-five obese (body mass index (BMI) a parts per thousand yen35 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) a parts per thousand currency sign6 % and fasting blood glucose (FBG) < 100 mg/dl in absence of all diabetic medications. 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). 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.
引用
收藏
页码:782 / 787
页数:6
相关论文
共 40 条
[1]   Preoperative Fasting Plasma C-Peptide Level May Help to Predict Diabetes Outcome After Gastric Bypass Surgery [J].
Aarts, E. O. ;
Janssen, J. ;
Janssen, I. M. C. ;
Berends, F. J. ;
Telting, D. ;
de Boer, H. .
OBESITY SURGERY, 2013, 23 (07) :867-873
[2]   Long-term effects of laparoscopic sleeve gastrectomy, gastric bypass, and adjustable gastric banding on type 2 diabetes [J].
Abbatini, F. ;
Rizzello, M. ;
Casella, G. ;
Alessandri, G. ;
Capoccia, D. ;
Leonetti, F. ;
Basso, N. .
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, 2010, 24 (05) :1005-1010
[3]   The impact of preoperative weight loss in patients undergoing Laparoscopic Roux-en-Y gastric bypass [J].
Alvarado, R ;
Alami, RS ;
Hsu, G ;
Safadi, BY ;
Sanchez, BR ;
Morton, JM ;
Curet, MJ .
OBESITY SURGERY, 2005, 15 (09) :1282-1286
[4]  
Anderson JW, 2001, AM J CLIN NUTR, V74, P579
[5]   The Surgical Treatment of Type II Diabetes Mellitus: Changes in HOMA Insulin Resistance in the First Year Following Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and Laparoscopic Adjustable Gastric Banding (LAGB) [J].
Ballantyne, Garth H. ;
Wasielewski, Annette ;
Saunders, John K. .
OBESITY SURGERY, 2009, 19 (09) :1297-1303
[6]   Use of Bariatric Outcomes Longitudinal Database (BOLD) to Study Variability in Patient Success After Bariatric Surgery [J].
Benoit, Stephen C. ;
Hunter, Tina D. ;
Francis, Diane M. ;
De La Cruz-Munoz, Nestor .
OBESITY SURGERY, 2014, 24 (06) :936-943
[7]   Type 2 diabetes after gastric bypass: remission in five models using HbA1c, fasting blood glucose, and medication status [J].
Blackstone, Robin ;
Bunt, Joy C. ;
Cortes, Melisa Celaya ;
Sugerman, Harvey J. .
SURGERY FOR OBESITY AND RELATED DISEASES, 2012, 8 (05) :548-555
[8]   Laparoscopic Roux-en-Y gastric bypass versus laparoscopic sleeve gastrectomy: a case-control study and 3 years of follow-up [J].
Boza, Camilo ;
Gamboa, Cristian ;
Salinas, Jose ;
Achurra, Pablo ;
Vega, Andrea ;
Perez, Gustavo .
SURGERY FOR OBESITY AND RELATED DISEASES, 2012, 8 (03) :243-249
[9]   Weight and Type 2 Diabetes after Bariatric Surgery: Systematic Review and Meta-analysis [J].
Buchwald, Henry ;
Estok, Rhonda ;
Fahrbach, Kyle ;
Banel, Deirdre ;
Jensen, Michael D. ;
Pories, Walter J. ;
Bantle, John P. ;
Sledge, Isabella .
AMERICAN JOURNAL OF MEDICINE, 2009, 122 (03) :248-U81
[10]   How Do We Define Cure of Diabetes? [J].
Buse, John B. ;
Caprio, Sonia ;
Cefalu, William T. ;
Ceriello, Antonio ;
Del Prato, Stefano ;
Inzucchi, Silvio E. ;
McLaughlin, Sue ;
Phillips, Gordon L., II ;
Robertson, R. Paul ;
Rubino, Francesco ;
Kahn, Richard ;
Kirkman, M. Sue .
DIABETES CARE, 2009, 32 (11) :2133-2135