Abstract
Bariatric surgery remains the most effective weight loss treatment. It leads to significant and sustained weight loss and improvement in various metabolic diseases such as type 2 diabetes (T2DM). This piece of work aimed to investigate the remission of T2DM amongst patients who had laparoscopic Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomies (LSG). This was achieved by carrying out a retrospective review of prospective data of 82 T2DM diabetic patients who had above bariatric surgery at the University Hospital Ayr from 2010 to 2016. Outcomes were assessed at two years postoperatively and documented. The main outcome measure was based on the achievement of partial or complete remission.The average age of patients in this study was 49.6±8.1 with 52% female (n=49) and 48% male (=33). Preoperative body mass index (BMI) averaged at 42.6±6.2 kgm2. The majority (n= 43) of cases had a Roux-en-Y gastric bypass (RYGB) while (n=39) had laparoscopic sleeve gastrectomy (LSG). The average glycated haemoglobin (HbA1c) was 6.7±1.8 units. Fourteen patients who had diet-controlled diabetes were excluded. Of the patients left (n=68), partial or complete remission was achieved by 73.3% (n =50). Remission rates following RYGB, 87.2% (n=43) were higher than those following LSG (55.2%). Age, duration of diabetes, and HbA1c showed a statistically significant difference amongst both cohorts. No statistically significant difference was seen in BMI both at referral and at surgery between both cohorts of patients.We concluded that preoperative BMI plays a very limited role in determining which patients go into remission in the short-term postoperative phase.
Highlights
Diabetes mellitus (DM) is a metabolic disorder in which there is an aberration in the secretion and/or action of insulin [1]
This involved a retrospective analysis of data from 82 T2DM patients who underwent either laparoscopic sleeve gastrectomy (LSG) or Roux-en-Y Gastric Bypass (RYGB) between 2010 and 2016
Our results show that complete or partial remission was achieved in up to 73% of diabetic patients who underwent bariatric surgery
Summary
Diabetes mellitus (DM) is a metabolic disorder in which there is an aberration in the secretion and/or action of insulin [1]. This leads to abnormal carbohydrate metabolism characterized by hyperglycemia. Chronic hyperglycemia is associated with significant microvascular and macrovascular complications [2]. These complications have a great impact on the patient’s health and quality of life, and their management poses a significant financial strain on the National Health Service (NHS) [3]. 415 million people have DM and 193 million have undiagnosed DM worldwide [4]. A further one-million people are thought to have undiagnosed DM [5]. It is predicted that more than 5million will be living with DM by 2025 in the UK [6]
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