Predictors of Short-Term Diabetes Remission After Laparoscopic Roux-en-Y Gastric Bypass

被引:12
|
作者
Iacobellis, Gianluca [1 ,4 ]
Xu, Chengyu [1 ,4 ]
Campo, Rafael E. [2 ,4 ]
De La Cruz-Munoz, Nestor F. [3 ,4 ]
机构
[1] Univ Miami, Div Diabet Endocrinol & Metab, Miami, FL 33136 USA
[2] Dept Med, Div Infect Dis, Miami, FL USA
[3] Univ Miami Hosp, Dept Surg, Div Laparoendoscop & Bariatr Surg, Miami, FL USA
[4] Univ Miami, Miller Sch Med, Miami, FL 33136 USA
关键词
RYGB; Type 2 diabetes mellitus; Obesity; Diabetes remission; BARIATRIC SURGERY; WEIGHT-LOSS; MEDICAL THERAPY; RISK-FACTORS; MELLITUS; OBESITY; PREVALENCE; PATIENT; IMPACT; ADULTS;
D O I
10.1007/s11695-014-1477-6
中图分类号
R61 [外科手术学];
学科分类号
摘要
A remission of type 2 diabetes mellitus (T2DM) is one of the major goals of the contemporary bariatric surgery. The goal of our study is to identify predictors of short-term postoperative diabetes remission in order to facilitate preoperative patient selection. Two hundred forty-five obese (body mass index (BMI) a parts per thousand yen35 kg/m2) T2DM subjects who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were followed up to 1 year after bariatric surgery. Diabetes remission was defined as hemoglobin A1c (HbA1c) a parts per thousand currency sign6 % and fasting blood glucose (FBG) < 100 mg/dl in absence of all diabetic medications. Twenty-six percent of the patients seen in f/u achieved complete remission at 1 year. Average Hba1c decreased from 8 to 6.7 % and 6.4 % after 6 and 12 months, respectively. Regression analysis showed that age (p = 0.01), number of diabetes complications (p = 0.03), family history of diabetes (p = 0.04), preoperative use of insulin (p = 0.04), and peri- and postoperative weight loss (p = 0.05, for both) were the best preoperative predictors of diabetes remission at 6 and 12 months (R (2) = 0.3). Younger patients, with fewer diabetic complications, no family history of diabetes, not using insulin, and with greater peri- and postoperative weight loss were the best candidates to achieve a rapid diabetes remission after RYGB.
引用
收藏
页码:782 / 787
页数:6
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