TUESDAY, Feb. 13, 2024 (HealthDay News) -- Despite weight regain (WR), type 2 diabetes mellitus (T2DM) remission rates are generally maintained after Roux-en-Y gastric bypass (RYGB), according to research published online Feb. 13 in the Journal of the American College of Surgeons.
Omar M. Ghanem, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues conducted a retrospective review of patients who underwent successful primary RYGB or sleeve gastrectomy (SG) with a body mass index ≥35 kg/m2 and preoperative diagnosis of T2DM. The rates of continued diabetes remission (CDR) were stratified into WR quartiles and compared after selecting the optimal procedure for glycemic control.
Data were analyzed for 224 RYGB and 46 SG patients. The overall rate of CDR was higher in the RYGB group than in the SG group (75 versus 34.8 percent). The odds of T2DM recurrence were 5.5 times higher after SG than after RYGB. On stratification into WR quartiles (<25, 25 to 44.9, 45 to 74.9, and >75 percent), the rates of CDR were 85.5, 81.7, 63.2, and 60 percent, respectively. Associations were seen for baseline insulin use, higher preoperative hemoglobin A1c, and longer preoperative duration of T2DM with T2DM recurrence; WR was not associated with T2DM recurrence.
"Despite WR not being an independent factor associated with T2DM recurrence, its importance cannot be overlooked," the authors write. "Some patients with complete WR after RYGB maintained significant CDR, further supporting a potential role of the proximal small intestines in metabolic control that is less dependent on the weight loss achieved through gastric restriction."
Several authors disclosed ties to the pharmaceutical and medical device industries.
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