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Clinical factors that predict remission of diabetes after different bariatric surgical procedures: interdisciplinary group of bariatric surgery of Verona (G.I.C.O.V.)

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Abstract

Aims

The aims of the study were to investigate weight loss and glycemic control parameters after different bariatric surgical procedures in type 2 diabetes (T2D) obese patients and identify patients’ factors that predict diabetes remission.

Methods

The study included 105 obese T2D patients (66 women and 39 men) who underwent laparoscopic gastric banding (LAGB, 11 subjects, age 47 ± 10 years, BMI 42.3 ± 8.3 kg/m2), or laparoscopic Roux-en-Y gastric bypass (RYBP, 77 subjects, age 50 ± 8 years, BMI 45.7 ± 6.8 kg/m2), or sleeve gastrectomy (SG, 17 subjects, age 49 ± 11 years, BMI 50.2 ± 8.8 kg/m2) during 2005–2012 period.

Results

The average percentage of weight loss at 12 months after surgery was 26.4 ± 9.8 %, and it was maintained at 24 and 36 months of follow-up. Diabetes remission occurred in 68.6 % of study participants (4/11 of LAGB, 54/77 of RYBP and 14/17 of SG). In multivariate Cox analysis, age, duration of diabetes, surgical procedure and glycated hemoglobin <53 mmol/mol (7 %) resulted significant predictors of diabetes remission (age RR = 0.97, 95 %CI 0.94–1.0, p = 0.05; diabetes duration RR = 0.93, 95 % CI 0.86–0.99, p = 0.036; rif LAGB, RYBP RR = 3.9, 95 % CI 1.31–11.57, p = 0.014; SG RR = 5.6, 95 % CI 1.67–18.64, p = 0.005; glycated hemoglobin RR = 0.54, 95 % CI 0.32–0.92, p = 0.024).

Conclusions

Bariatric surgical procedures that modify the upper gastrointestinal tract anatomy (RYBP and SG) are more successful in producing weight loss and remission of T2D than those that simply restrict stomach capacity (LAGB). Younger age, short duration of diabetes and better glucose control confer higher probability of achieving remission of diabetes.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

The study has been reviewed by the Ethic Committee of the University of Verona, and has been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki.

Informed consent

Informed consent was obtained from all patients for being included in the study.

Author information

Authors and Affiliations

  1. Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, UOC Endocrinologia, University and University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy

    Maria Grazia Zenti, Ilaria Rubbo, Giulia Ceradini, Elisabetta Rinaldi, Enzo Bonora & Giacomo Zoppini

  2. USD Clinical Psychology, Department of Medicine, University Hospital of Verona, Verona, Italy

    Luisa Nadalini

  3. Division of Bariatric Surgery, Department of Surgery, University Hospital of Verona, Verona, Italy

    Marco Battistoni & Michele Genna

Authors
  1. Maria Grazia Zenti
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  2. Ilaria Rubbo
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  3. Giulia Ceradini
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  4. Elisabetta Rinaldi
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  5. Luisa Nadalini
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  6. Marco Battistoni
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  7. Michele Genna
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  8. Enzo Bonora
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  9. Giacomo Zoppini
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Correspondence to Maria Grazia Zenti.

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Zenti, M.G., Rubbo, I., Ceradini, G. et al. Clinical factors that predict remission of diabetes after different bariatric surgical procedures: interdisciplinary group of bariatric surgery of Verona (G.I.C.O.V.). Acta Diabetol 52, 937–942 (2015). https://doi.org/10.1007/s00592-015-0738-8

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  • DOI: https://doi.org/10.1007/s00592-015-0738-8

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