PMID- 38348897
OWN - NLM
STAT- Publisher
LR  - 20240213
IS  - 1743-9159 (Electronic)
IS  - 1743-9159 (Linking)
DP  - 2024 Feb 9
TI  - Preoperative duration of type 2 diabetes mellitus and remission after Roux-en-Y 
      gastric bypass: A single center long-term cohort study.
LID - 10.1097/JS9.0000000000001139 [doi]
AB  - BACKGROUND: Roux-en-Y gastric bypass (RYGB) has demonstrated excellent glycemic 
      control and type 2 diabetes mellitus (T2DM) remission for patients with obesity 
      and T2DM. Duration of T2DM is a consistent negative predictor of remission after 
      RYGB. However, the exact timing to offer surgical intervention during the course 
      of the disease is not well elucidated. MATERIAL AND METHODS: We performed a 
      retrospective cohort study between 2008-2020 to establish the exact association 
      between duration of T2DM and remission after RYGB. We divided our cohort into 
      quartiles of preoperative disease duration to quantify the change in remission 
      rates for each year of delay between T2DM diagnosis and RYGB. We also compared 
      the average time to remission and changes in glycemic control parameters. 
      RESULTS: A total of 519 patients (67.2% female; age 53.4+/-10.7 y; BMI 
      46.6+/-8.4 kg/m2) with a follow-up period of 6.6+/-3.8 years were included. Remission 
      was demonstrated in 51% of patients. Longer duration of T2DM was a significant 
      negative predictor of remission with an estimated decrease in remission rates of 
      7% for each year of delay ([OR=0.931 (95% CI 0.892-0.971)]; P<0.001). Compared to 
      patients with <3 years of T2DM, remission decreased by 37% for patients with 3-6 
      years, 64% for those with 7-12 years and 81% for patients with more than 12 years 
      (P<0.001). Half of the patients reached T2DM remission after 0.5 and 1.1 years 
      respectively for the first and second quartiles, while patients in the other 
      quartiles never reached 50% remission. Lastly, we noted an overall improvement in 
      all glycemic control parameters for all quartiles at last follow-up. CONCLUSION: 
      Patients with a recent history of T2DM who undergo early RYGB experience 
      significantly higher and earlier T2DM remission compared to patients with a 
      prolonged history of preoperative T2DM, suggesting potential benefit of early 
      surgical intervention to manage patients with obesity and T2DM.
CI  - Copyright (c) 2024 The Author(s). Published by Wolters Kluwer Health, Inc.
FAU - Hage, Karl
AU  - Hage K
AD  - Department of Surgery, Mayo Clinic Rochester, MN, USA.
FAU - Abi Mosleh, Kamal
AU  - Abi Mosleh K
AD  - Department of Surgery, Mayo Clinic Rochester, MN, USA.
FAU - Sample, Jack W
AU  - Sample JW
AD  - Department of Surgery, Mayo Clinic Rochester, MN, USA.
FAU - Vierkant, Robert A
AU  - Vierkant RA
AD  - Department of Quantitative Health Sciences, Mayo Clinic Rochester, MN, USA.
FAU - Mundi, Manpreet S
AU  - Mundi MS
AD  - Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic 
      Rochester, MN, USA.
FAU - Spaniolas, Konstantinos
AU  - Spaniolas K
AD  - Division of Endocrine and Metabolic Surgery, Department of Surgery, Health 
      Sciences Center, Stony Brook Medicine, Stony Brook, NY, USA.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA.
FAU - Ghanem, Omar M
AU  - Ghanem OM
AD  - Department of Surgery, Mayo Clinic Rochester, MN, USA.
LA  - eng
PT  - Journal Article
DEP - 20240209
PL  - United States
TA  - Int J Surg
JT  - International journal of surgery (London, England)
JID - 101228232
SB  - IM
EDAT- 2024/02/13 12:46
MHDA- 2024/02/13 12:46
CRDT- 2024/02/13 08:21
PHST- 2023/11/28 00:00 [received]
PHST- 2024/01/25 00:00 [accepted]
PHST- 2024/02/13 12:46 [medline]
PHST- 2024/02/13 12:46 [pubmed]
PHST- 2024/02/13 08:21 [entrez]
AID - 01279778-990000000-01041 [pii]
AID - 10.1097/JS9.0000000000001139 [doi]
PST - aheadofprint
SO  - Int J Surg. 2024 Feb 9. doi: 10.1097/JS9.0000000000001139.