PMID- 16269382
OWN - NLM
STAT- MEDLINE
DCOM- 20060316
LR  - 20221207
IS  - 1091-255X (Print)
IS  - 1091-255X (Linking)
VI  - 9
IP  - 8
DP  - 2005 Nov
TI  - Is Roux-en-Y gastric bypass surgery the most effective treatment for type 2 
      diabetes mellitus in morbidly obese patients?
PG  - 1112-6; discussion 1117-8
AB  - Type 2 diabetes mellitus (T2DM) has a very strong association with obesity. The 
      aim of our study was to analyze the effects of Roux-en-Y gastric bypass (RYGB) 
      surgery on the glucose metabolism in morbidly obese patients with T2DM. Morbidly 
      obese patients (n = 117) with T2DM underwent measurements of fasting serum 
      glucose and glycosylated hemoglobin (HbA1C) at baseline, 6 months, and 12 months 
      after laparoscopic RYGB surgery. Logistic regression was used in both univariate 
      and multivariate modeling to identify independent variables associated with 
      complete resolution of T2DM. Twelve months after surgery, fasting plasma glucose 
      decreased from a preoperative mean of 164 +/- 55 mg/dL to 101 +/- 38 mg/dL (P = 
      .001) and HbA1C decreased from a preoperative mean of 7.7% +/- 1.5% to 6.0% +/- 
      1.1% (P = .001). Resolution of T2DM was achieved in 72 patients (74%). All of the 
      remaining 25 patients decreased the daily medication requirements. On univariate 
      analysis, preoperative variables associated with resolution of T2DM were waist 
      circumference, HbA1C, and absence of insulin treatment. Waist circumference (odds 
      ratio 2.4; 95% confidence interval 1.4-4.1; P = .001) and treatment without 
      insulin (odds ratio 42.2; 95% confidence interval 4.3-417.3; P = .002) remained 
      significant predictors of T2DM resolution in the multivariate logistic regression 
      model after adjusting for covariates. Laparoscopic RYGBP resulted in significant 
      resolution of T2DM. Peripheral fat distribution (smaller waist circumference) and 
      absence of insulin treatment were independent and significant predictors of 
      complete resolution of T2DM.
FAU - Torquati, Alfonso
AU  - Torquati A
AD  - Department of Surgery, Vanderbilt University Medical School, Nashville, Tennessee 
      37232, USA. alfonso.torquati@vanderbilt.edu
FAU - Lutfi, Rami
AU  - Lutfi R
FAU - Abumrad, Naji
AU  - Abumrad N
FAU - Richards, William O
AU  - Richards WO
LA  - eng
GR  - K12RR017697-03/RR/NCRR NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - Netherlands
TA  - J Gastrointest Surg
JT  - Journal of gastrointestinal surgery : official journal of the Society for Surgery 
      of the Alimentary Tract
JID - 9706084
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Adult
MH  - *Anastomosis, Roux-en-Y
MH  - Blood Glucose/analysis
MH  - Diabetes Mellitus, Type 2/complications/*surgery
MH  - Female
MH  - Gastric Bypass/*methods
MH  - Glycated Hemoglobin/analysis
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Obesity, Morbid/complications/*surgery
MH  - Treatment Outcome
EDAT- 2005/11/05 09:00
MHDA- 2006/03/17 09:00
CRDT- 2005/11/05 09:00
PHST- 2005/05/20 00:00 [received]
PHST- 2005/07/21 00:00 [accepted]
PHST- 2005/11/05 09:00 [pubmed]
PHST- 2006/03/17 09:00 [medline]
PHST- 2005/11/05 09:00 [entrez]
AID - S1091-255X(05)00584-6 [pii]
AID - 10.1016/j.gassur.2005.07.016 [doi]
PST - ppublish
SO  - J Gastrointest Surg. 2005 Nov;9(8):1112-6; discussion 1117-8. doi: 
      10.1016/j.gassur.2005.07.016.