PMID- 31550092 OWN - NLM STAT- MEDLINE DCOM- 20200410 LR - 20240328 IS - 1488-2310 (Electronic) IS - 0008-428X (Print) IS - 0008-428X (Linking) VI - 62 IP - 5 DP - 2019 Oct 1 TI - Predictive factors for diabetes remission after bariatric surgery. PG - 315-319 AB - BACKGROUND: Bariatric surgery has been shown to induce type 2 diabetes mellitus (T2DM) remission in severely obese patients. After laparoscopic Roux-en-Y gastric bypass (LRYGB), diabetes remission occurs early and independently of weight loss. Previous research has identified preoperative factors for remission, such as duration of diabetes and HbA1c. Understanding factors that predict diabetes remission can help to select patients who will benefit most from bariatric surgery. METHODS: We retrospectively reviewed all T2DM patients who underwent laparoscopic sleeve gastrectomy (LSG) or LRYGB between January 2008 and July 2014. The primary outcome was diabetes remission, defined as the absence of hypoglycemic medications, fasting blood glucose < 7.0 mmol/L and HbA1c < 6.5%. Data were analyzed using multivariable logistic regression analysis to identify predictive factors of diabetes remission. RESULTS: We included 207 patients in this analysis; 84 (40.6%) had LSG and 123 (59.4%) had LRYGB. Half of the patients (49.8%) achieved diabetes remission at 1 year. Multivariable logistic analysis showed that LRYGB had higher odds of diabetes remission than LSG (odds ratio [OR] 6.58, 95% confidence interval [CI] 2.79-15.50, p < 0.001). Shorter duration of diabetes (OR 0.91, 95% CI 0.83-0.99, p = 0.032) and the absence of long-acting insulin (OR 0.0011, 95% CI < 0.000-0.236, p = 0.013) predicted remission. CONCLUSION: Type of bariatric procedure (LRYGB v. LSG), shorter duration of diabetes and the absence of long-acting insulin were independent predictors of diabetes remission after bariatric surgery. CI - (c) 2019 Joule Inc. or its licensors FAU - Dang, Jerry T AU - Dang JT AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Sheppard, Caroline AU - Sheppard C AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Kim, David AU - Kim D AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Switzer, Noah AU - Switzer N AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Shi, Xinzhe AU - Shi X AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Tian, Chunhong AU - Tian C AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - de Gara, Christopher AU - de Gara C AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Karmali, Shahzeer AU - Karmali S AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). FAU - Birch, Daniel W AU - Birch DW AD - From the Department of Surgery, University of Alberta, Edmonton, Alta. (Dang, Switzer); the Department of Surgery, University of British Columbia, Vancouver, BC (Kim); and the Centre for the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandra Hospital, Edmonton, Alta. (Sheppard, Shi, Tian, Karmali, Birch). LA - eng PT - Journal Article PL - Canada TA - Can J Surg JT - Canadian journal of surgery. Journal canadien de chirurgie JID - 0372715 RN - 0 (Blood Glucose) RN - 0 (Glycated Hemoglobin A) RN - 0 (Hypoglycemic Agents) RN - 0 (Insulin, Long-Acting) RN - 0 (hemoglobin A1c protein, human) MH - Adult MH - Bariatric Surgery/*methods MH - Blood Glucose/analysis MH - Canada MH - Diabetes Mellitus, Type 2/blood/diagnosis/*therapy MH - Female MH - Glycated Hemoglobin/analysis MH - Humans MH - Hypoglycemic Agents/therapeutic use MH - Insulin, Long-Acting/therapeutic use MH - Male MH - Middle Aged MH - Obesity, Morbid/blood/*surgery MH - Prognosis MH - Remission Induction/*methods MH - Retrospective Studies MH - Time Factors MH - Treatment Outcome PMC - PMC7006352 COIS- S. Karmali is a consultant for Gore Medical and Ethicon. D. Birch is a consultant and has received educational grants from Ethicon and Covidien, educational grants from Stryker, and teaching honoraria from Cook Surgery and Bard Davol. No other competing interests declared. EDAT- 2019/09/25 06:00 MHDA- 2020/04/11 06:00 PMCR- 2019/10/01 CRDT- 2019/09/25 06:00 PHST- 2019/09/25 06:00 [entrez] PHST- 2019/09/25 06:00 [pubmed] PHST- 2020/04/11 06:00 [medline] PHST- 2019/10/01 00:00 [pmc-release] AID - 0620315 [pii] AID - 10.1503/cjs.014516 [doi] PST - ppublish SO - Can J Surg. 2019 Oct 1;62(5):315-319. doi: 10.1503/cjs.014516.