How accurate are DiaRem, Ad-DiaRem or DiaBetter scores in predicting diabetes remission 10 years after gastric bypass?

2021 ◽  
Author(s):  
Mariana Monteiro ◽  
Marta Guimarães ◽  
Sofia S. Pereira ◽  
Catarina Osório ◽  
Diogo Silva ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Diabetes Remission

Presence of Liver Steatosis Is Associated With Greater Diabetes Remission After Gastric Bypass Surgery

2020 ◽  
Author(s):  
Roman Vangoitsenhoven ◽  
Rickesha Wilson ◽  
Deepa V Cherla ◽  
Chao Tu ◽  
Sangeeta R Kashyap ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Metabolic Surgery ◽  
Gastric Bypass Surgery ◽  
Liver Steatosis ◽  
Multivariable Analysis ◽  
Diabetes Remission ◽  
Independent Association ◽  
Glycemic Outcomes ◽  
Design And Methods

<b>Objective</b>: Type 2 diabetes mellitus (T2DM) is characterized by insulin resistance (IR) and beta-cell dysfunction. Ectopic fat accumulation in liver and muscle causes IR. Since bariatric and metabolic surgery significantly improves fatty liver disease, <a>we hypothesized that coexistence of liver steatosis (i.e., when hepatic IR contributes in T2DM) would be associated with greater diabetes improvement after surgery.</a> <p> </p> <p><b>Research design and methods</b>: A total of 519 patients with T2DM who underwent Roux-en-Y gastric bypass and simultaneous liver biopsy and had a minimum 5-year follow-up were analyzed to assess the independent association between biopsy-proven liver steatosis and postoperative long-term diabetes remission (glycated hemoglobin < 6.5% off medications).</p> <p> </p> <p><b>Results</b>: Of the 407 patients with biopsy-proven liver steatosis, long-term diabetes remission was achieved in 211 (52%) patients, compared with 44/112 (39%) remission in patients without steatosis (P=0.027). In multivariable analysis, presence of liver steatosis was an independent predictor of long-term diabetes remission (odds ratio 1.96, [95% confidence interval 1.04 – 3.72], <i>P</i>=0.038). Hepatocyte ballooning, lobular inflammation, or fibrosis at baseline did not predict diabetes remission.</p> <p> </p> <p><b>Conclusion</b>: This study, for the first time, suggests that in patients with T2DM who are considering bariatric and metabolic surgery, coexistence of liver steatosis is associated with better long-term glycemic outcomes. Furthermore, our data suggest that there are different variants of T2DM wherein metabolic responses to surgical weight loss are different. A subgroup of patients whose T2DM is characterized by the presence of hepatic steatosis (presumably associated with worse IR) experience better postoperative metabolic outcomes.</p>

scholarly journals Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
First Generation ◽  
Hemoglobin A1c ◽  
Diabetes Remission ◽  
Factors Associated ◽  
Generation Immigrant

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.

scholarly journals The advanced-DiaRem score improves prediction of diabetes remission 1 year post-Roux-en-Y gastric bypass

Diabetologia ◽  
2017 ◽  
Vol 60 (10) ◽  
pp. 1892-1902 ◽  
Author(s):  
Judith Aron-Wisnewsky ◽  
Nataliya Sokolovska ◽  
Yuejun Liu ◽  
Doron S. Comaneshter ◽  
Shlomo Vinker ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Diabetes Remission ◽  
Prediction Of Diabetes

scholarly journals Evaluation of the Effects of Bariatric Surgery in Terms of Weight Loss and Diabetes Remission in the Indian Population

2021 ◽  
pp. 1-7
Author(s):  
Manish Khaitan ◽  
Riddhish Gadani ◽  
Koshish Nandan Pokharel
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Complete Remission ◽  
Predictive Factors ◽  
Indian Population ◽  
Diabetes Remission ◽  
Obese Patients ◽  
Sustained Weight Loss

<b><i>Objectives:</i></b> The growing prevalence of obesity rates worldwide is associated with an upsurge in its comorbidities, particularly type 2 diabetes mellitus (T2DM). Bariatric surgery is a proven treatment modality for producing sustained weight loss and resolution of associated T2DM providing marked improvement in quality of life with rapid recovery. This study aims to investigate the effects of laparoscopic sleeve gastrectomy (LSG), Roux-en-Y gastric bypass (RYGB), and mini-gastric bypass (MGB) on obese patients suffering from T2DM in the Indian population and their long-term association with regard to diabetes remission, resolution of comorbidities, and percentage EWL. <b><i>Methods:</i></b> Retrospective data of obese patients with T2DM (preoperative BMI 45.37 ± 8.1) who underwent bariatric surgery (RYGB, LSG, and MGB) were analyzed in this study over a period of 9 years. The mean follow-up period was 2.2 years. Following surgery, the clinical outcome on BMI, resolution of percentage weight loss, and T2DM were studied. The predictive factors of diabetic remission after surgery were determined. Student’s <i>t</i> test and ANOVA and McNemar’s test were applied. <b><i>Results:</i></b> Out of a total of 274 patients, complete remission of T2DM was achieved in 52.9% (<i>n</i> = 145) with mean fasting blood glucose and glycated hemoglobin values being 6.1 ± 0.769 (<i>p</i> = 0.00) at 1 year after surgery. The independent predictive factors of remission were age, gender, BMI, preoperative comorbidities, and % EWL. Gender had no correlation with the chance of achieving disease remission. <b><i>Conclusion:</i></b> Based on our results, bariatric surgery proves to be a successful treatment option resulting in sustained weight loss in obese patients suffering from T2DM. It is found to be beneficial for the long-term resolution of T2DM and improving comorbidities such as hypertension and dyslipidemia. The outcome of the different surgical methods is found to be similar for all patients irrespective of the independent predictors of complete remission.

scholarly journals The Nonlinear Relationship Between Psoas Cross-sectional Area and BMI: A New Observation and Its Insights into Diabetes Remission After Roux-en-Y Gastric Bypass

2021 ◽  
Author(s):  
Shaobo Li ◽  
Haoyong Yu ◽  
Pin Zhang ◽  
Yinfang Tu ◽  
Yunfeng Xiao ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Linear Relationship ◽  
Muscle Mass ◽  
Diabetes Remission ◽  
Cross Sectional Area ◽  
Fat Free Mass ◽  
Sectional Area ◽  
Cross Sectional ◽  
Non Linear ◽  
Design And Methods

OBJECTIVE <p>To<a> explore the potential relevance of muscle mass as a variable contributor to body mass index (BMI) on BMI limitations in predicting diabetes remission (DR) after Roux-en-Y gastric bypass (RYGB). </a></p> <p> </p> <p>RESEARCH DESIGN AND METHODS</p> <p>We evaluated the relationship between muscle mass and BMI in 501 patients with type 2 diabetes mellitus and overweight or obesity. Of which <a>186 patients who underwent R</a>YGB were <a>studied to determine the role of baseline muscle mass </a><a>and BMI </a>in predicting DR. Muscle mass was assessed by estimated fat-free mass index (eFFMI) and psoas cross-sectional area (CSA).</p> <p> </p> <p>RESULTS</p> <p>A non-linear relationship existed between psoas CSA and BMI, whereas psoas CSA showed a highly positive correlation with <a>eFFMI</a>. Baseline psoas CSA and eFFMI were better than BMI for predicting 1- and 5-year DR. </p> <p> </p> <p>CONCLUSIONS</p> <p><a>The </a><a>non-linear relationship between</a> muscle mass and BMI may <a>partially contribute to </a><a>BMI limitations in predicting DR</a> after RYGB. </p>

Sign in / Sign up

Export Citation Format

Share Document