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- Title
Predictors of Remission of T2DM and Metabolic Effects after Laparoscopic Roux-en-y Gastric Bypass in Obese Indian Diabetics-a 5-Year Study.
- Authors
Bhasker, Aparna; Remedios, Carlyne; Batra, Payal; Sood, Amit; Shaikh, Shehla; Lakdawala, Muffazal
- Abstract
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, 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). 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.
- Subjects
BARIATRIC surgery; GASTRIC bypass; METABOLIC disorders; TYPE 2 diabetes; LIPOPROTEIN lipase
- Publication
Obesity Surgery, 2015, Vol 25, Issue 7, p1191
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-014-1501-x