BACKGROUND: Bariatric surgery has proven results for diabetes remission in obese diabetics. Despite this, a lot of ambiguity exists around patient selection. The objectives of this study are the following: (1) evaluation of results of laparoscopic Roux-en-y gastric bypass (LRYGB) in obese type 2 diabetic (T2DM) Indian patients at 5 years and (2) to define predictors of success after surgery. METHODS: This is a prospective observational study. One hundred six Indian patients underwent LRYGB from January 2004 to July 2009. Patients were evaluated for percent excess weight loss (%EWL) and remission of T2DM. Mean age 50.34 ± 9.08 years, mean waist circumference 129.8 ± 20.8 cm, mean weight 119.2 ± 23.6 kg, mean BMI 45.01 ± 7.9 kg/m(2), and mean duration of diabetes 8.2 ± 6.2 years. RESULTS: At 5 years, mean EWL% was 61.4 ± 20.3, mean weight regain of 8.6 ± 6.2 kg was seen in 63.6 %, mean glycosylated hemoglobin dropped from 8.7 ± 2.1 to 6.2 ± 01.3 %, mean triglycerides declined by 31 %, and serum high density lipoprotein rose by 18.4 %. Mean low-density lipoprotein levels declined by 6.8 %. Age, BMI, fasting C-peptide levels, duration of T2DM, and pre-op use of insulin emerged as significant predictors of success after surgery. One hundred percent remission was seen in patients with T2DM <5 years. CONCLUSIONS: LRYGB is safe and efficacious for long-term remission of T2DM (BMI ≥ 35 kg/m(2)). In a country with the second largest population of type 2 diabetics in the world, predictors of success after surgery can help in prioritizing patients who have a greater chance to benefit from metabolic surgery.
BACKGROUND: Bariatric surgery has proven results for diabetes remission in obese diabetics. Despite this, a lot of ambiguity exists around patient selection. The objectives of this study are the following: (1) evaluation of results of laparoscopic Roux-en-y gastric bypass (LRYGB) in obese type 2 diabetic (T2DM) Indian patients at 5 years and (2) to define predictors of success after surgery. METHODS: This is a prospective observational study. One hundred six Indian patients underwent LRYGB from January 2004 to July 2009. Patients were evaluated for percent excess weight loss (%EWL) and remission of T2DM. Mean age 50.34 ± 9.08 years, mean waist circumference 129.8 ± 20.8 cm, mean weight 119.2 ± 23.6 kg, mean BMI 45.01 ± 7.9 kg/m(2), and mean duration of diabetes 8.2 ± 6.2 years. RESULTS: At 5 years, mean EWL% was 61.4 ± 20.3, mean weight regain of 8.6 ± 6.2 kg was seen in 63.6 %, mean glycosylated hemoglobin dropped from 8.7 ± 2.1 to 6.2 ± 01.3 %, mean triglycerides declined by 31 %, and serum high density lipoprotein rose by 18.4 %. Mean low-density lipoprotein levels declined by 6.8 %. Age, BMI, fasting C-peptide levels, duration of T2DM, and pre-op use of insulin emerged as significant predictors of success after surgery. One hundred percent remission was seen in patients with T2DM <5 years. CONCLUSIONS: LRYGB is safe and efficacious for long-term remission of T2DM (BMI ≥ 35 kg/m(2)). In a country with the second largest population of type 2 diabetics in the world, predictors of success after surgery can help in prioritizing patients who have a greater chance to benefit from metabolic surgery.
Authors: Joseph A Houmard; Charles J Tanner; Chunli Yu; Paul G Cunningham; Walter J Pories; Kenneth G MacDonald; Gerald I Shulman Journal: Diabetes Date: 2002-10 Impact factor: 9.461
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Authors: W J Pories; M S Swanson; K G MacDonald; S B Long; P G Morris; B M Brown; H A Barakat; R A deRamon; G Israel; J M Dolezal Journal: Ann Surg Date: 1995-09 Impact factor: 12.969
Authors: Julia S Kenkre; Ahmed R Ahmed; Sanjay Purkayastha; Khalefah Malallah; Stephen Bloom; Alexandra I Blakemore; A Toby Prevost; Tricia Tan Journal: BMJ Open Date: 2021-02-10 Impact factor: 2.692