PMID- 22968072
OWN - NLM
STAT- MEDLINE
DCOM- 20130122
LR  - 20121116
IS  - 1528-1140 (Electronic)
IS  - 0003-4932 (Linking)
VI  - 256
IP  - 6
DP  - 2012 Dec
TI  - Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on 
      type 2 diabetes mellitus in morbidly obese subjects.
PG  - 1023-9
LID - 10.1097/SLA.0b013e318262ee6b [doi]
AB  - OBJECTIVE: To identify the rates and the predictors of long-term remission and 
      the recurrence of type 2 diabetes mellitus (T2DM) after Roux-en-Y gastric bypass 
      (RYGBP) or sleeve gastrectomy (SG). BACKGROUND: The durability of the improvement 
      of T2DM after bariatric surgery is not well characterized. METHODS: One hundred 
      fifty-three subjects with T2DM (RYGBP: n = 98; SG: n = 55) were evaluated for 
      remission and recurrence of the disease throughout 35.4 +/- 13.5 months' follow-up. 
      The type of surgery, demographic, anthropometric, and biochemical parameters were 
      ascertained as predictors of T2DM outcomes. Glucagon-like peptide 1 (GLP-1) 
      responses after a standard mixed liquid meal were compared between patients 
      presenting with T2DM remission after RYGBP or SG. RESULTS: 75.2% of subjects 
      presented with remission of T2DM lasting at least 12 months. However, in 12.1% of 
      subjects, T2DM recurred. Regression analysis showed a longer duration of T2DM (P 
      = 0.006), a higher presurgical glycated hemoglobin level (P = 0.019), insulin 
      treatment at baseline (P = 0.001), and a lower excess weight loss at last 
      follow-up visit (P < 0.001) as independent predictors for the lack of T2DM 
      remission. Insulin use before surgery (P = 0.005), an older age (P = 0.05), and 
      weight regain after remission (P = 0.021) predicted recurrence of the disease. 
      Long-term remission of T2DM after SG or RYGBP was associated with a comparably 
      enlarged GLP-1 response to a standard mixed liquid meal challenge. CONCLUSIONS: 
      Roux-en-Y gastric bypass and SG are associated with comparable remission rates of 
      T2DM. However, insufficient weight loss or weight regain in those with a more 
      advanced disease may hamper the benefits of these surgical techniques on T2DM.
FAU - Jimenez, Amanda
AU  - Jimenez A
AD  - Obesity Unit, Endocrinology and Diabetes Department, Hospital Clinic 
      Universitari, Villarroel 170, 08036 Barcelona, Spain.
FAU - Casamitjana, Roser
AU  - Casamitjana R
FAU - Flores, Lilliam
AU  - Flores L
FAU - Viaplana, Judith
AU  - Viaplana J
FAU - Corcelles, Ricard
AU  - Corcelles R
FAU - Lacy, Antonio
AU  - Lacy A
FAU - Vidal, Josep
AU  - Vidal J
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Ann Surg
JT  - Annals of surgery
JID - 0372354
SB  - IM
CIN - Nat Rev Endocrinol. 2012 Nov;8(11):626. PMID: 23032178
MH  - Diabetes Complications/*surgery
MH  - Diabetes Mellitus, Type 2/*complications/*surgery
MH  - Female
MH  - Gastrectomy/*methods
MH  - *Gastric Bypass
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*complications/*surgery
MH  - Prospective Studies
MH  - Remission Induction
EDAT- 2012/09/13 06:00
MHDA- 2013/01/23 06:00
CRDT- 2012/09/13 06:00
PHST- 2012/09/13 06:00 [entrez]
PHST- 2012/09/13 06:00 [pubmed]
PHST- 2013/01/23 06:00 [medline]
AID - 10.1097/SLA.0b013e318262ee6b [doi]
PST - ppublish
SO  - Ann Surg. 2012 Dec;256(6):1023-9. doi: 10.1097/SLA.0b013e318262ee6b.