Predictors of Remission of T2DM and Metabolic Effects after Laparoscopic Roux-en-y Gastric Bypass in Obese Indian Diabetics—a 5-Year Study

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 diab...

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Published in:	Obesity surgery 2015-07, Vol.25 (7), p.1191-1197
Main Authors:	Bhasker, Aparna Govil, Remedios, Carlyne, Batra, Payal, Sood, Amit, Shaikh, Shehla, Lakdawala, Muffazal
Format:	Article
Language:	eng
Subjects:	Adult C-Peptide - blood Diabetes Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - surgery Female Gastric Bypass - methods Gastrointestinal surgery Glycated Hemoglobin A - metabolism Humans India Laparoscopy - methods Lipoproteins, LDL - blood Male Medicine Medicine & Public Health Middle Aged Obesity Obesity, Morbid - blood Obesity, Morbid - complications Obesity, Morbid - surgery Original Contributions Prospective Studies Surgery Treatment Outcome Triglycerides - blood Waist Circumference - physiology Weight Loss - physiology
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Summary:	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
ISSN:	0960-8923 1708-0428