Laparoscopic Roux-en-Y gastric bypass was associated with significantly higher odds of diabetes remission at 1 year compared to sleeve gastrectomy (OR 6.58; 95% CI 2.79-15.50; p < 0.001).
Cohort (n=207)
Does LRYGB compared to LSG improve diabetes remission in patients with T2DM?
LRYGB is associated with significantly higher odds of diabetes remission at 1 year compared to LSG, with shorter diabetes duration and absence of long-acting insulin also predicting remission.
Effect estimate: OR 6.58 (95% CI 2.79-15.50)
p-value: p=< 0.001
Background: Bariatric surgery has been shown to induce type 2 diabetes mellitus (T2DM) remission in severely obese patients. After laparoscopic Roux-en-Y gastric bypass (LRYGB), diabetes remission occurs early and independently of weight loss. Previous research has identified preoperative factors for remission, such as duration of diabetes and HbA1c. Understanding factors that predict diabetes remission can help to select patients who will benefit most from bariatric surgery. Methods: We retrospectively reviewed all T2DM patients who underwent laparoscopic sleeve gastrectomy (LSG) or LRYGB between January 2008 and July 2014. The primary outcome was diabetes remission, defined as the absence of hypoglycemic medications, fasting blood glucose < 7.0 mmol/L and HbA1c < 6.5%. Data were analyzed using multivariable logistic regression analysis to identify predictive factors of diabetes remission. Results: We included 207 patients in this analysis; 84 (40.6%) had LSG and 123 (59.4%) had LRYGB. Half of the patients (49.8%) achieved diabetes remission at 1 year. Multivariable logistic analysis showed that LRYGB had higher odds of diabetes remission than LSG (odds ratio OR 6.58, 95% confidence interval CI 2.79–15.50, p < 0.001). Shorter duration of diabetes (OR 0.91, 95% CI 0.83–0.99, p = 0.032) and the absence of long-acting insulin (OR 0.0011, 95% CI < 0.000–0.236, p = 0.013) predicted remission. Conclusion: Type of bariatric procedure (LRYGB v. LSG), shorter duration of diabetes and the absence of long-acting insulin were independent predictors of diabetes remission after bariatric surgery.
Dang et al. (Wed,) conducted a cohort in Type 2 diabetes mellitus and severe obesity (n=207). Laparoscopic Roux-en-Y gastric bypass (LRYGB) vs. Laparoscopic sleeve gastrectomy (LSG) was evaluated on Diabetes remission (absence of hypoglycemic medications, fasting blood glucose < 7.0 mmol/L and HbA1c < 6.5%) (OR 6.58, 95% CI 2.79-15.50, p=< 0.001). Laparoscopic Roux-en-Y gastric bypass was associated with significantly higher odds of diabetes remission at 1 year compared to sleeve gastrectomy (OR 6.58; 95% CI 2.79-15.50; p < 0.001).