Key result
Roux-en-Y gastric bypass increased 2-year diabetes remission odds versus sleeve gastrectomy (OR 2.51; 95% CI 1.12-5.60; P=0.025), but this became non-significant when adjusted for weight loss.
Why the study?
Does Roux-en-Y gastric bypass improve diabetes remission compared to sleeve gastrectomy in obese patients with diabetes?
Cohort (n=383)
No
Does Roux-en-Y gastric bypass improve diabetes remission compared to sleeve gastrectomy in obese patients with diabetes?
Answers are grounded in this paper and cite their sources.
Both DiaBetter and DiaRem scores accurately predict diabetes remission following bariatric surgery, with 2-year weight loss being the primary driver of remission rather than the specific surgical procedure.
The aim of this study was to compare the DiaRem with the DiaBetter score that includes diabetes duration, upon combined (complete plus partial) 2-year post-surgery diabetes remission in people following RYGB and sleeve gastrectomy, and to investigate the relationship between weight loss and diabetes remission. METHODS: A retrospective single-centre cohort study of obese people with diabetes who underwent RYGB (107) or sleeve gastrectomy (103) and a validation cohort study (173) were undertaken. Diabetes remission, % weight loss, DiaRem, DiaBetter scores and areas under receiving operator characteristic (ROC) curves were calculated. The relationship between % weight loss and diabetes remission was investigated using logistic regression. RESULTS: The proportion of people achieving diabetes remission was highest for those with the lowest DiaBetter and DiaRem scores. Areas under the ROC curves were comparable [DiaBetter: 0.867 (95%CI: 0.817-0.916); DiaRem: 0.865 (95%CI: 0.814-0.915), P=0.856]. Two-year % weight loss was higher post RYGB [26.6 (95%CI: 24.8-28.4)] vs post-sleeve gastrectomy [20.6 (95%CI: 18.3-22.8), P<0.001]. RYGB had 151% higher odds of diabetes remission [OR 2.51 (95%CI: 1.12-5.60), P=0.025]. This association became non-significant when adjusted for % weight loss. CONCLUSION: DiaBetter and DiaRem scores predict diabetes remission following both procedures. Two-year % weight loss plays a key role in determining diabetes remission.
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Pucci et al. (2017) conducted a cohort in Obesity with diabetes (n=383). Roux-en-Y gastric bypass vs. Sleeve gastrectomy was evaluated on Diabetes remission at 2 years (OR 2.51, 95% CI 1.12-5.60, p=0.025). Roux-en-Y gastric bypass increased 2-year diabetes remission odds versus sleeve gastrectomy (OR 2.51; 95% CI 1.12-5.60; P=0.025), but this became non-significant when adjusted for weight loss.
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