PMID- 38349010
OWN - NLM
STAT- MEDLINE
DCOM- 20240418
LR  - 20240424
IS  - 1879-1190 (Electronic)
IS  - 1072-7515 (Linking)
VI  - 238
IP  - 5
DP  - 2024 May 1
TI  - Continued Diabetes Remission Despite Weight Recurrence: Gastric Bypass Long-Term 
      Metabolic Benefit.
PG  - 862-871
LID - 10.1097/XCS.0000000000000934 [doi]
AB  - BACKGROUND: Roux-en-Y gastric bypass (RYGB) demonstrates high rates of type 2 
      diabetes mellitus (T2DM) remission, a phenomenon hypothesized to be mediated 
      mainly by weight loss. Compared with procedures that do not bypass the proximal 
      small intestines, such as sleeve gastrectomy (SG), RYGB exhibits weight 
      loss-independent intestinal mechanisms conducive to T2DM remission. We 
      investigated continued diabetes remission (CDR) rates despite weight recurrence 
      (WR) after RYGB compared with an SG cohort. STUDY DESIGN: A retrospective review 
      of patients who underwent successful primary RYGB or SG with a BMI value of 
      35 kg/m 2 or more and a preoperative diagnosis of T2DM was performed. Patients 
      with less than 5 years of follow-up, absence of WR, or lack of T2DM remission at 
      nadir weight were excluded. After selecting the optimal procedure for glycemic 
      control, rates of CDR were then stratified into WR quartiles and compared. 
      RESULTS: A total of 224 RYGB and 46 SG patients were analyzed. The overall rate 
      of CDR was significantly higher in the RYGB group (75%) compared with the SG 
      group (34.8%; p < 0.001). The odds of T2DM recurrence were 5.5 times higher after 
      SG compared with RYGB. Rates of CDR were stratified into WR quartiles (85.5%, 
      <25%; 81.7%, 25% to 44.9%; 63.2%, 45% to 74.9%; and 60%, >75%). Baseline insulin 
      use, higher preoperative glycosylated hemoglobin, and longer preoperative 
      duration of T2DM were associated with T2DM recurrence, whereas WR was not. 
      CONCLUSIONS: T2DM remission rates after RYGB are maintained despite WR, arguing 
      for a concurrent weight loss-independent metabolic benefit likely facilitated by 
      bypassing the proximal small intestine.
CI  - Copyright (c) 2024 by the American College of Surgeons. Published by Wolters Kluwer 
      Health, Inc. All rights reserved.
FAU - Ghanem, Omar M
AU  - Ghanem OM
AD  - From the Department of Surgery (Ghanem, Abi Mosleh, Hage), Mayo Clinic, 
      Rochester, MN.
FAU - Abi Mosleh, Kamal
AU  - Abi Mosleh K
AD  - From the Department of Surgery (Ghanem, Abi Mosleh, Hage), Mayo Clinic, 
      Rochester, MN.
FAU - Kerbage, Anthony
AU  - Kerbage A
AD  - Division of Gastroenterology, Department of Medicine (Kerbage, Abu Dayyeh), Mayo 
      Clinic, Rochester, MN.
FAU - Lu, Lauren
AU  - Lu L
AD  - Mayo Clinic Alix School of Medicine (Lu), Mayo Clinic, Rochester, MN.
FAU - Hage, Karl
AU  - Hage K
AD  - From the Department of Surgery (Ghanem, Abi Mosleh, Hage), Mayo Clinic, 
      Rochester, MN.
FAU - Abu Dayyeh, Barham K
AU  - Abu Dayyeh BK
AD  - Division of Gastroenterology, Department of Medicine (Kerbage, Abu Dayyeh), Mayo 
      Clinic, Rochester, MN.
LA  - eng
PT  - Journal Article
DEP - 20240417
PL  - United States
TA  - J Am Coll Surg
JT  - Journal of the American College of Surgeons
JID - 9431305
SB  - IM
MH  - Humans
MH  - *Gastric Bypass/methods
MH  - *Diabetes Mellitus, Type 2/surgery/complications
MH  - *Obesity, Morbid/surgery/complications
MH  - Retrospective Studies
MH  - Gastrectomy/methods
MH  - Weight Loss
MH  - Treatment Outcome
EDAT- 2024/02/13 12:45
MHDA- 2024/04/18 06:44
CRDT- 2024/02/13 08:29
PHST- 2024/04/18 06:44 [medline]
PHST- 2024/02/13 12:45 [pubmed]
PHST- 2024/02/13 08:29 [entrez]
AID - 00019464-202405000-00013 [pii]
AID - 10.1097/XCS.0000000000000934 [doi]
PST - ppublish
SO  - J Am Coll Surg. 2024 May 1;238(5):862-871. doi: 10.1097/XCS.0000000000000934. 
      Epub 2024 Apr 17.