Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication

Background/purpose: Few studies evaluating the mid-term outcome of type 2 diabetes mellitus (t2DM) after Roux-en-Y Gastric Bypass (RYGB) are available at this time. The aim of this study is to assess mid-term impact of RYGB on t2DM regarding the need for anti-diabetic medication, biochemical respons...

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Principais autores: Gys, Ben, Haenen, Filip, Gys, Tobie, Lafullarde, Thierry
Formato: Online
Idioma:por
Publicado em: FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE, BRAZIL
Endereço do item:https://periodicos.ufrn.br/jscr/article/view/11411
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spelling oai:periodicos.ufrn.br:article-114112017-03-02T13:21:01Z Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication Gys, Ben Haenen, Filip Gys, Tobie Lafullarde, Thierry Obesity Diabetes mellitus Bariatric surgery Background/purpose: Few studies evaluating the mid-term outcome of type 2 diabetes mellitus (t2DM) after Roux-en-Y Gastric Bypass (RYGB) are available at this time. The aim of this study is to assess mid-term impact of RYGB on t2DM regarding the need for anti-diabetic medication, biochemical response and associated weight loss. Methods: Retrospective analysis of prospectively collected data was performed for patients suffering from t2DM who underwent RYGB between 1/1/2000 and 1/1/2015. Patients were divided into 2 groups according to the preoperative need for insulin. Study parameters included Body Mass Index (BMI), %Excess Weight Loss (%EWL), Hemoglobin A1c (HbA1c) and fasting glucose at 1, 3, 6 and 10-year intervals after surgery. Results: 140 patients (97 women, 43 men) were included. Mean preoperative BMI was 42.8 kg/m² (range 35.0 - 75.0). Mean duration of t2DM before RYGB was 5,7 years (range 0,2 - 30,1). Preoperative need for anti-diabetic medication was seen in 102 patients (72,8%) of which 49 (48,0%) were insulin-dependent (ID-group).  Mean postoperative follow-up was 5,9 years (range 0,1 – 14,5). Remission of t2DM (fasting glucose < 126mg/dl and a HbA1c < 6.5% without the need of anti-diabetic medication for at least 6 months) was present in both groups: 46,7%, 48,1%, 45,0%, 50,0% (ID-group) and 59,1%, 62,2%, 53,3%, 33,3% (insulin independent patients) at respectively 1, 3, 6 and 10-years follow up. No significant correlation was proven between remission and %EWL. Conclusions: Bariatric surgery is useful in the mid-term management of uncontrolled t2DM. FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE, BRAZIL 2017-03-02 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://periodicos.ufrn.br/jscr/article/view/11411 JOURNAL OF SURGICAL AND CLINICAL RESEARCH; Vol. 7 No. 2 (2016); 40-49 JOURNAL OF SURGICAL AND CLINICAL RESEARCH; v. 7 n. 2 (2016); 40-49 2179-7889 por https://periodicos.ufrn.br/jscr/article/view/11411/8045 Copyright (c) 2017 JOURNAL OF SURGICAL AND CLINICAL RESEARCH
institution Periódicos UFRN
collection Portal de Pediódicos Eletrônicos da UFRN
language por
format Online
author Gys, Ben
Haenen, Filip
Gys, Tobie
Lafullarde, Thierry
spellingShingle Gys, Ben
Haenen, Filip
Gys, Tobie
Lafullarde, Thierry
Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
author_facet Gys, Ben
Haenen, Filip
Gys, Tobie
Lafullarde, Thierry
author_sort Gys, Ben
title Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
title_short Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
title_full Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
title_fullStr Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
title_full_unstemmed Mid-term effect of Roux-en-Y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
title_sort mid-term effect of roux-en-y gastric bypass on type 2 diabetes mellitus: a retrospective single surgeon observational study with focus on anti-diabetic medication
description Background/purpose: Few studies evaluating the mid-term outcome of type 2 diabetes mellitus (t2DM) after Roux-en-Y Gastric Bypass (RYGB) are available at this time. The aim of this study is to assess mid-term impact of RYGB on t2DM regarding the need for anti-diabetic medication, biochemical response and associated weight loss. Methods: Retrospective analysis of prospectively collected data was performed for patients suffering from t2DM who underwent RYGB between 1/1/2000 and 1/1/2015. Patients were divided into 2 groups according to the preoperative need for insulin. Study parameters included Body Mass Index (BMI), %Excess Weight Loss (%EWL), Hemoglobin A1c (HbA1c) and fasting glucose at 1, 3, 6 and 10-year intervals after surgery. Results: 140 patients (97 women, 43 men) were included. Mean preoperative BMI was 42.8 kg/m² (range 35.0 - 75.0). Mean duration of t2DM before RYGB was 5,7 years (range 0,2 - 30,1). Preoperative need for anti-diabetic medication was seen in 102 patients (72,8%) of which 49 (48,0%) were insulin-dependent (ID-group).  Mean postoperative follow-up was 5,9 years (range 0,1 – 14,5). Remission of t2DM (fasting glucose < 126mg/dl and a HbA1c < 6.5% without the need of anti-diabetic medication for at least 6 months) was present in both groups: 46,7%, 48,1%, 45,0%, 50,0% (ID-group) and 59,1%, 62,2%, 53,3%, 33,3% (insulin independent patients) at respectively 1, 3, 6 and 10-years follow up. No significant correlation was proven between remission and %EWL. Conclusions: Bariatric surgery is useful in the mid-term management of uncontrolled t2DM.
publisher FEDERAL UNIVERSITY OF RIO GRANDE DO NORTE, BRAZIL
publishDate 2017
url https://periodicos.ufrn.br/jscr/article/view/11411
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