Prediction of Diabetes Remission in Morbidly Obese Patients After Roux-en-Y Gastric Bypass

Background

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.

Methods

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.

Results

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.

Conclusion

The predictive factors for diabetes remission after RYGB include age at operation, HbA1c and C-peptide levels, and the %TWL after surgery.