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Published in: Obesity Surgery 2/2015

Open Access 01-02-2015 | Original Contributions

Predictive Factors of Type 2 Diabetes Mellitus Remission Following Bariatric Surgery: a Meta-analysis

Authors: Guo-Feng Wang, Yong-Xin Yan, Ning Xu, Dong Yin, Yuan Hui, Ji-Ping Zhang, Guan-Jun Han, Ning Ma, Yan Wu, Jing-Zi Xu, Tao Yang

Published in: Obesity Surgery | Issue 2/2015

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Abstract

Background

Although a few studies have been reported on predictive factors of postoperative diabetes remission, the conclusions remain inconsistent. This meta-analysis aimed to assess the preoperative clinical factors for type 2 diabetes mellitus (T2DM) remission after bariatric surgery.

Methods

The Cochrane Library, PubMed, MEDLINE, Embase, and CINAHL databases were searched. All human studies published in English between 1 January 1992 and 1 September 2013 reporting on the parameters of interest were included.

Results

In total, 15 studies involving 1,753 bariatric surgery patients were selected. Analyses were performed separately for the parameters of interest. T2DM remission was observed to be negatively correlated with age, diabetes duration, insulin use, and HbA1c levels. Baseline body mass index (BMI) and C-peptide levels were positively associated with the remission rate in Asian patients. However, there was no significant association between gender and remission rate.

Conclusions

Patients with younger age, short diabetes duration, better glucose control, and better β cell function were more likely to achieve T2DM remission after bariatric surgery. However, further randomized controlled trials with uniform remission criteria should be conducted to provide more reliable evidence.
Literature
1.
go back to reference Gill RS, Birch DW, Shi X, et al. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis. 2010;6(6):707–13.PubMedCrossRef Gill RS, Birch DW, Shi X, et al. Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Surg Obes Relat Dis. 2010;6(6):707–13.PubMedCrossRef
2.
go back to reference Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(248–256):e245. Buchwald H, Estok R, Fahrbach K, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(248–256):e245.
3.
go back to reference Meijer RI, van Wagensveld BA, Siegert CE, et al. Bariatric surgery as a novel treatment for type 2 diabetes mellitus: a systematic review. Arch Surg. 2011;146:744–50.PubMedCrossRef Meijer RI, van Wagensveld BA, Siegert CE, et al. Bariatric surgery as a novel treatment for type 2 diabetes mellitus: a systematic review. Arch Surg. 2011;146:744–50.PubMedCrossRef
4.
go back to reference Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258(4):628–36.PubMedCentralPubMed Brethauer SA, Aminian A, Romero-Talamás H, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg. 2013;258(4):628–36.PubMedCentralPubMed
5.
go back to reference Liberati A, Altman D, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.PubMedCentralPubMedCrossRef Liberati A, Altman D, Tetzlaff J, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6(7):e1000100.PubMedCentralPubMedCrossRef
7.
go back to reference Admiraal WM, Dallal RM, Celik F, et al. Ethnic differences in weight loss and diabetes remission after bariatric surgery. Diabetes Care. 2012;35:1951–8.PubMedCentralPubMedCrossRef Admiraal WM, Dallal RM, Celik F, et al. Ethnic differences in weight loss and diabetes remission after bariatric surgery. Diabetes Care. 2012;35:1951–8.PubMedCentralPubMedCrossRef
8.
go back to reference Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238(4):467–84. discussion 84–5.PubMedCentralPubMed Schauer PR, Burguera B, Ikramuddin S, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003;238(4):467–84. discussion 84–5.PubMedCentralPubMed
9.
go back to reference DiGiorgi M, Rosen DJ, Choi JJ, et al. Re-emergence of diabetes after gastric bypass in patients with mid- to long-term follow-up. Surg Obes Relat Dis. 2010;6:249–53.PubMedCrossRef DiGiorgi M, Rosen DJ, Choi JJ, et al. Re-emergence of diabetes after gastric bypass in patients with mid- to long-term follow-up. Surg Obes Relat Dis. 2010;6:249–53.PubMedCrossRef
10.
go back to reference Hayes MT, Hunt LA, Foo J, et al. A model for predicting the resolution of type 2 diabetes in severely obese subjects following Roux-en Y gastric bypass surgery. Obes Surg. 2011;21:910–9.PubMedCrossRef Hayes MT, Hunt LA, Foo J, et al. A model for predicting the resolution of type 2 diabetes in severely obese subjects following Roux-en Y gastric bypass surgery. Obes Surg. 2011;21:910–9.PubMedCrossRef
11.
go back to reference Huang CK, Shabbir A, Lo CH, et al. Laparoscopic Roux-en-Y gastric bypass for the treatment of type II diabetes mellitus in Chinese patients with body mass index of 25–35. Obes Surg. 2011;21:1344–9.PubMedCentralPubMedCrossRef Huang CK, Shabbir A, Lo CH, et al. Laparoscopic Roux-en-Y gastric bypass for the treatment of type II diabetes mellitus in Chinese patients with body mass index of 25–35. Obes Surg. 2011;21:1344–9.PubMedCentralPubMedCrossRef
12.
go back to reference Nannipieri M, Mari A, Anselmino M, et al. The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab. 2011;96:E1372–9.PubMedCrossRef Nannipieri M, Mari A, Anselmino M, et al. The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab. 2011;96:E1372–9.PubMedCrossRef
13.
go back to reference Kadera BE, Lum K, Grant J, et al. Remission of type 2 diabetes after Roux-en-Y gastric bypass is associated with greater weight loss. Surg Obes Relat Dis. 2009;5:305–9.PubMedCrossRef Kadera BE, Lum K, Grant J, et al. Remission of type 2 diabetes after Roux-en-Y gastric bypass is associated with greater weight loss. Surg Obes Relat Dis. 2009;5:305–9.PubMedCrossRef
14.
go back to reference Kim S, Richards WO. Long-term follow-up of the metabolic profiles in obese patients with type 2 diabetes mellitus after Roux-en-Y gastric bypass. Ann Surg. 2010;251:1049–55.PubMedCrossRef Kim S, Richards WO. Long-term follow-up of the metabolic profiles in obese patients with type 2 diabetes mellitus after Roux-en-Y gastric bypass. Ann Surg. 2010;251:1049–55.PubMedCrossRef
15.
go back to reference Jiménez A, Casamitjana R, Flores L, et al. Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256(6):1023–9.PubMedCrossRef Jiménez A, Casamitjana R, Flores L, et al. Long-term effects of sleeve gastrectomy and Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus in morbidly obese subjects. Ann Surg. 2012;256(6):1023–9.PubMedCrossRef
16.
go back to reference Kim MK, Lee HC, Kwon HS, et al. Visceral obesity is a negative predictor of remission of diabetes 1 year after bariatric surgery. Obesity. 2011;19(9):1835–9.PubMedCrossRef Kim MK, Lee HC, Kwon HS, et al. Visceral obesity is a negative predictor of remission of diabetes 1 year after bariatric surgery. Obesity. 2011;19(9):1835–9.PubMedCrossRef
17.
go back to reference Biro SM, Olson DL, Garren MJ, et al. Diabetes remission and glycemic response to pre-bariatric surgery diet. J Surg Res. 2013;185(1):1–5.PubMedCrossRef Biro SM, Olson DL, Garren MJ, et al. Diabetes remission and glycemic response to pre-bariatric surgery diet. J Surg Res. 2013;185(1):1–5.PubMedCrossRef
18.
go back to reference Blackstone R, Bunt JC, Cortés MC, et al. Type 2 diabetes after gastric bypass: remission in five models using HbA1c, fasting blood glucose, and medication status. Surg Obes Relat Dis. 2012;8(5):548–55.PubMedCrossRef Blackstone R, Bunt JC, Cortés MC, et al. Type 2 diabetes after gastric bypass: remission in five models using HbA1c, fasting blood glucose, and medication status. Surg Obes Relat Dis. 2012;8(5):548–55.PubMedCrossRef
19.
go back to reference Ramos-Levi A, Sanchez-Pernaute A, Matia P, et al. Diagnosis of diabetes remission after bariatic surgery may be jeopardized by remission criteria and previous hypoglycemic treatment. Obes Surg. 2013;23(10):1520–6.PubMedCrossRef Ramos-Levi A, Sanchez-Pernaute A, Matia P, et al. Diagnosis of diabetes remission after bariatic surgery may be jeopardized by remission criteria and previous hypoglycemic treatment. Obes Surg. 2013;23(10):1520–6.PubMedCrossRef
20.
go back to reference Torquati A, Lutfi R, Abumrad N, et al. Is Roux-en-Y gastric bypass surgery the most effective treatment for type 2 diabetes mellitus in morbidly obese patients? J Gastrointest Surg. 2005;9(8):1112–6.PubMedCrossRef Torquati A, Lutfi R, Abumrad N, et al. Is Roux-en-Y gastric bypass surgery the most effective treatment for type 2 diabetes mellitus in morbidly obese patients? J Gastrointest Surg. 2005;9(8):1112–6.PubMedCrossRef
21.
go back to reference Hirsch FF, Pareja JC, Geloneze SR, et al. Comparison of metabolic effects of surgical-induced massive weight loss in patients with long-term remission versus non-remission of type 2 diabetes. Obes Surg. 2012;22(6):910–7.PubMedCrossRef Hirsch FF, Pareja JC, Geloneze SR, et al. Comparison of metabolic effects of surgical-induced massive weight loss in patients with long-term remission versus non-remission of type 2 diabetes. Obes Surg. 2012;22(6):910–7.PubMedCrossRef
22.
go back to reference Yan H, Tang L, Chen T, et al. Defining and predicting complete remission of type 2 diabetes: a short-term efficacy study of open gastric bypass. Obes Facts. 2013;6(2):176–84.PubMedCrossRef Yan H, Tang L, Chen T, et al. Defining and predicting complete remission of type 2 diabetes: a short-term efficacy study of open gastric bypass. Obes Facts. 2013;6(2):176–84.PubMedCrossRef
23.
go back to reference Pournaras D, Aasheim E, Sovik T, et al. Remission of type 2 diabetes mellitus after bariatric surgery according to the 2009 American Diabetes Association Criteria. 28th Annual Meeting of the American Society for Metabolic and Bariatric Surgery, Orlando, FL, USA, (2011) A05:pp 247–248. Pournaras D, Aasheim E, Sovik T, et al. Remission of type 2 diabetes mellitus after bariatric surgery according to the 2009 American Diabetes Association Criteria. 28th Annual Meeting of the American Society for Metabolic and Bariatric Surgery, Orlando, FL, USA, (2011) A05:pp 247–248.
24.
go back to reference Hall TC, Pellen MG, Sedman PC, et al. Preoperative factors predicting remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass surgery for obesity. Obes Surg. 2010;20(9):1245–50.PubMedCrossRef Hall TC, Pellen MG, Sedman PC, et al. Preoperative factors predicting remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass surgery for obesity. Obes Surg. 2010;20(9):1245–50.PubMedCrossRef
25.
go back to reference Perna M, Romagnuolo J, Morgan K, et al. Preoperative hemoglobin A1c and postoperative glucose control in outcomes after gastric bypass for obesity. Surg Obes Relat Dis. 2012;8(6):685–90.PubMedCrossRef Perna M, Romagnuolo J, Morgan K, et al. Preoperative hemoglobin A1c and postoperative glucose control in outcomes after gastric bypass for obesity. Surg Obes Relat Dis. 2012;8(6):685–90.PubMedCrossRef
26.
go back to reference Arterburn DE, Bogart A, Sherwood NE, et al. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg. 2013;23(1):93–102.PubMedCrossRef Arterburn DE, Bogart A, Sherwood NE, et al. A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg. 2013;23(1):93–102.PubMedCrossRef
27.
go back to reference Schernthaner G, Brix JM, Kopp HP, et al. Cure of type 2 diabetes by metabolic surgery? A critical analysis of the evidence in 2010. Diabetes Care. 2011;34 Suppl 2:S355–60.PubMedCentralPubMedCrossRef Schernthaner G, Brix JM, Kopp HP, et al. Cure of type 2 diabetes by metabolic surgery? A critical analysis of the evidence in 2010. Diabetes Care. 2011;34 Suppl 2:S355–60.PubMedCentralPubMedCrossRef
28.
go back to reference Vetter ML, Cardillo S, Rickels MR, et al. Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Ann Intern Med. 2009;150:94–103.PubMedCrossRef Vetter ML, Cardillo S, Rickels MR, et al. Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Ann Intern Med. 2009;150:94–103.PubMedCrossRef
29.
go back to reference Ramos-Levi AM, Cabrerizo L, Matía P, et al. Which criteria should be used to define type 2 diabetes remission after bariatric surgery? BMC Surg. 2013;13:8.PubMedCentralPubMedCrossRef Ramos-Levi AM, Cabrerizo L, Matía P, et al. Which criteria should be used to define type 2 diabetes remission after bariatric surgery? BMC Surg. 2013;13:8.PubMedCentralPubMedCrossRef
30.
go back to reference Dixon JB, Chuang LM, Chong K, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care. 2013;36:20–6.PubMedCentralPubMedCrossRef Dixon JB, Chuang LM, Chong K, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care. 2013;36:20–6.PubMedCentralPubMedCrossRef
31.
go back to reference Hamza N, Abbas MH, Darwish A, et al. Predictors of remission of type 2 diabetes mellitus after laparoscopic gastric banding and bypass. Surg Obes Relat Dis. 2011;7(6):691–6.PubMedCrossRef Hamza N, Abbas MH, Darwish A, et al. Predictors of remission of type 2 diabetes mellitus after laparoscopic gastric banding and bypass. Surg Obes Relat Dis. 2011;7(6):691–6.PubMedCrossRef
32.
go back to reference Kang KC, Shin SH, Lee YJ, et al. Influence of gastrectomy for stomach cancer on type 2 diabetes mellitus for patients with a body mass index less than 30 kg/m(2). J Korean Surg Soc. 2012;82(6):347–55.PubMedCentralPubMedCrossRef Kang KC, Shin SH, Lee YJ, et al. Influence of gastrectomy for stomach cancer on type 2 diabetes mellitus for patients with a body mass index less than 30 kg/m(2). J Korean Surg Soc. 2012;82(6):347–55.PubMedCentralPubMedCrossRef
33.
go back to reference Hills CE, Brunskill NJ. Cellular and physiological effects of C-peptide and long term complications of diabetes. Pediatr Diabetes. 2011;12:276–92.CrossRef Hills CE, Brunskill NJ. Cellular and physiological effects of C-peptide and long term complications of diabetes. Pediatr Diabetes. 2011;12:276–92.CrossRef
34.
go back to reference Brandenburg D. History and diagnostic significance of C-peptide. Exp Diabetes Res 2008: 576862. Brandenburg D. History and diagnostic significance of C-peptide. Exp Diabetes Res 2008: 576862.
35.
go back to reference Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366:1577–85.PubMedCrossRef Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012;366:1577–85.PubMedCrossRef
36.
go back to reference Schauer P, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:1567–76.PubMedCentralPubMedCrossRef Schauer P, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:1567–76.PubMedCentralPubMedCrossRef
37.
go back to reference Lee WJ, Lee YC, Ser KH, et al. Improvements of insulin resistance after obesity surgery: a comparison of gastric banding and bypass procedures. Obes Surg. 2008;18:1119–25.PubMedCrossRef Lee WJ, Lee YC, Ser KH, et al. Improvements of insulin resistance after obesity surgery: a comparison of gastric banding and bypass procedures. Obes Surg. 2008;18:1119–25.PubMedCrossRef
38.
go back to reference Scopinaro N, Adami GF, Papadia FS, et al. The effects of biliopancreatic diversion on type 2 diabetes mellitus in patients with mild obesity (BMI 30-35 kg/m2) and simple overweight (BMI 25-30 kg/m2): a prospective controlled study. Obes Surg. 2011;21:880–8.PubMedCrossRef Scopinaro N, Adami GF, Papadia FS, et al. The effects of biliopancreatic diversion on type 2 diabetes mellitus in patients with mild obesity (BMI 30-35 kg/m2) and simple overweight (BMI 25-30 kg/m2): a prospective controlled study. Obes Surg. 2011;21:880–8.PubMedCrossRef
39.
go back to reference Scopinaro N, Adami GF, Papadia FS, et al. Effects of biliopanceratic diversion on type 2 diabetes in patients with BMI 25 to 35. Ann Surg. 2011;253:699–703.PubMedCrossRef Scopinaro N, Adami GF, Papadia FS, et al. Effects of biliopanceratic diversion on type 2 diabetes in patients with BMI 25 to 35. Ann Surg. 2011;253:699–703.PubMedCrossRef
40.
41.
go back to reference Kim MK, Lee HC, Lee SH, et al. The difference of glucostatic parameters according to the remission of diabetes after Roux-en-Y gastric bypass. Diabetes Metab Res Rev. 2012;28(5):439–46.PubMedCrossRef Kim MK, Lee HC, Lee SH, et al. The difference of glucostatic parameters according to the remission of diabetes after Roux-en-Y gastric bypass. Diabetes Metab Res Rev. 2012;28(5):439–46.PubMedCrossRef
Metadata
Title
Predictive Factors of Type 2 Diabetes Mellitus Remission Following Bariatric Surgery: a Meta-analysis
Authors
Guo-Feng Wang
Yong-Xin Yan
Ning Xu
Dong Yin
Yuan Hui
Ji-Ping Zhang
Guan-Jun Han
Ning Ma
Yan Wu
Jing-Zi Xu
Tao Yang
Publication date
01-02-2015
Publisher
Springer US
Published in
Obesity Surgery / Issue 2/2015
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-014-1391-y

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