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Published in: Obesity Surgery 8/2017

01-08-2017 | Original Contributions

Do Bariatric Surgery-Related Type 2 Diabetes Remission Predictors Add Clinical Value? A Study on Asian Indian Obese Diabetics

Authors: P. Praveen Raj, Siddhartha Bhattacharya, S. Saravana Kumar, Sandeep C. Sabnis, R. Parthasarathi, Parimala Devi Kumara Swamy, C. Palanivelu

Published in: Obesity Surgery | Issue 8/2017

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Abstract

Background

Bariatric surgery has emerged to be the most effective treatment strategy for the treatment of obesity and type 2 diabetes mellitus (T2DM) achieving high remission rates. Many factors have been evaluated with a potential to predict the improvement of glycemic control following bariatric procedures. This study aims to study the various predictive factors for T2DM and the ABCD score in obese diabetic patients undergoing bariatric surgery in a South Indian population.

Methods

A total of 53 obese patients (BMI > 30 k/m2) with T2DM who underwent laparoscopic sleeve gastrectomy (LSG) and laparoscopic gastric bypass (LGB) from March 2014 to March 2015 were selected for the study. The patients were followed up to study the effects of various predictors of T2DM remission at 1 year.

Results

Out of the 53 patients, 35 (66%) underwent LSG and 18 (34%) underwent LGB. Patients (81.1%) had T2DM remission. Mean HbA1c values decreased from 8.07 ± 1.98 to 6.0 ± 0.71. Only higher pre-operative body weight (p = 0.04) and lower HbA1c level (p = 0.04) were significantly associated with T2DM remission. Higher absolute weight loss (p = 0.03) after surgery was also significantly associated with T2DM remission. ABCD score was not significantly associated with T2DM remission although patients with ABCD score higher than 7 demonstrated 100% remission rate.

Conclusion

Among all the factors, only higher pre-operative weight and better glycaemic control along with better post-operative weight loss were significantly associated with the remission of T2DM. Although not significantly associated with remission of T2DM, higher ABCD scores had higher likelihood of remission.
Literature
1.
go back to reference Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.CrossRefPubMed Wild S, Roglic G, Green A, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–53.CrossRefPubMed
2.
go back to reference Barry JDMT, Stephens JW. Predicting the resolution of type 2 diabetes after bariatric surgical procedures: a concise review. J Diabetes Metab. 2015;6(10):1–5.CrossRef Barry JDMT, Stephens JW. Predicting the resolution of type 2 diabetes after bariatric surgical procedures: a concise review. J Diabetes Metab. 2015;6(10):1–5.CrossRef
4.
go back to reference Lee W-J, Chong K, Chen J-C, et al. Predictors of diabetes remission after bariatric surgery in Asia. Asian J Surg. 2012;35(2):67–73.CrossRefPubMed Lee W-J, Chong K, Chen J-C, et al. Predictors of diabetes remission after bariatric surgery in Asia. Asian J Surg. 2012;35(2):67–73.CrossRefPubMed
5.
go back to reference Still CD, Wood GC, Benotti P, et al. Preoperative prediction of type 2 diabetes remission after roux-en-Y gastric bypass surgery: a retrospective cohort study. Lancet Diabetes Endocrinol. 2014;2(1):38–45.CrossRefPubMedPubMedCentral Still CD, Wood GC, Benotti P, et al. Preoperative prediction of type 2 diabetes remission after roux-en-Y gastric bypass surgery: a retrospective cohort study. Lancet Diabetes Endocrinol. 2014;2(1):38–45.CrossRefPubMedPubMedCentral
6.
go back to reference Ugale S, Gupta N, Modi KD, et al. Prediction of remission after metabolic surgery using a novel scoring system in type 2 diabetes—a retrospective cohort study. J Diabetes Metab Disord. 2014;13(1):89.CrossRefPubMedPubMedCentral Ugale S, Gupta N, Modi KD, et al. Prediction of remission after metabolic surgery using a novel scoring system in type 2 diabetes—a retrospective cohort study. J Diabetes Metab Disord. 2014;13(1):89.CrossRefPubMedPubMedCentral
7.
go back to reference Lee WJ, Hur KY, Lakadawala M, et al. Predicting success of metabolic surgery: age, body mass index, C-peptide, and duration score. Surg Obes Relat Dis. 2013;9(3):379–84.CrossRefPubMed Lee WJ, Hur KY, Lakadawala M, et al. Predicting success of metabolic surgery: age, body mass index, C-peptide, and duration score. Surg Obes Relat Dis. 2013;9(3):379–84.CrossRefPubMed
8.
go back to reference Tests D, Diabetes FOR. 2. Classification and diagnosis of diabetes. Diabetes Care. 2016;39:S13–22.CrossRef Tests D, Diabetes FOR. 2. Classification and diagnosis of diabetes. Diabetes Care. 2016;39:S13–22.CrossRef
9.
go back to reference Lee WJ, Almulaifi A, Chong K, et al. The effect and predictive score of gastric bypass and sleeve gastrectomy on type 2 diabetes mellitus patients with BMI < 30 kg/m2. Obes Surg. 2015;25(10):1772–8.CrossRefPubMed Lee WJ, Almulaifi A, Chong K, et al. The effect and predictive score of gastric bypass and sleeve gastrectomy on type 2 diabetes mellitus patients with BMI < 30 kg/m2. Obes Surg. 2015;25(10):1772–8.CrossRefPubMed
10.
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.CrossRefPubMed 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.CrossRefPubMed
11.
go back to reference Huang C-K, Shabbir A, Lo C-H, 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(9):1344–9.CrossRefPubMedPubMedCentral Huang C-K, Shabbir A, Lo C-H, 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(9):1344–9.CrossRefPubMedPubMedCentral
12.
go back to reference Wang G-F, Yan Y-X, Xu N, et al. Predictive factors of type 2 diabetes mellitus remission following bariatric surgery: a meta-analysis. Obes Surg. 2015;25(2):199–208.CrossRefPubMed Wang G-F, Yan Y-X, Xu N, et al. Predictive factors of type 2 diabetes mellitus remission following bariatric surgery: a meta-analysis. Obes Surg. 2015;25(2):199–208.CrossRefPubMed
13.
go back to reference Bhasker AG, Remedios C, Batra P, et al. Predictors of remission of T2DM and metabolic effects after laparoscopic roux-en-y gastric bypass in obese Indian diabetics-a 5-year study. Obes Surg. 2015;25(7):1191–7.CrossRefPubMed Bhasker AG, Remedios C, Batra P, et al. Predictors of remission of T2DM and metabolic effects after laparoscopic roux-en-y gastric bypass in obese Indian diabetics-a 5-year study. Obes Surg. 2015;25(7):1191–7.CrossRefPubMed
14.
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(17):1577–85.CrossRefPubMed 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(17):1577–85.CrossRefPubMed
15.
go back to reference Panunzi S, De Gaetano A, Carnicelli A, et al. Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatric surgery: do BMI or procedure choice matter? A meta-analysis Ann Surg. 2015;261(3):459–67.PubMed Panunzi S, De Gaetano A, Carnicelli A, et al. Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatric surgery: do BMI or procedure choice matter? A meta-analysis Ann Surg. 2015;261(3):459–67.PubMed
16.
go back to reference Dixon JB, Chuang L-M, Chong K, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care. 2013;36(1):20–6.CrossRefPubMed Dixon JB, Chuang L-M, Chong K, et al. Predicting the glycemic response to gastric bypass surgery in patients with type 2 diabetes. Diabetes Care. 2013;36(1):20–6.CrossRefPubMed
17.
go back to reference Robert M, Ferrand-Gaillard C, Disse E, et al. Predictive factors of type 2 diabetes remission 1 year after bariatric surgery: impact of surgical techniques. Obes Surg. 2013;23(6):770–5.CrossRefPubMed Robert M, Ferrand-Gaillard C, Disse E, et al. Predictive factors of type 2 diabetes remission 1 year after bariatric surgery: impact of surgical techniques. Obes Surg. 2013;23(6):770–5.CrossRefPubMed
18.
go back to reference Lee W-J, Hur KY, Lakadawala M, et al. Gastrointestinal metabolic surgery for the treatment of diabetic patients: a multi-institutional international study. J Gastrointest Surg. 2012;16(1):42–5.CrossRef Lee W-J, Hur KY, Lakadawala M, et al. Gastrointestinal metabolic surgery for the treatment of diabetic patients: a multi-institutional international study. J Gastrointest Surg. 2012;16(1):42–5.CrossRef
19.
go back to reference Cersosimo E, Triplitt C, Mandarino LJ, DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, et al., editors. South Dartmouth (MA); 2000. Cersosimo E, Triplitt C, Mandarino LJ, DeFronzo RA. Pathogenesis of type 2 diabetes mellitus. In: De Groot LJ, Beck-Peccoz P, Chrousos G, Dungan K, Grossman A, Hershman JM, et al., editors. South Dartmouth (MA); 2000.
20.
go back to reference Jurowich C, Thalheimer A, Hartmann D, et al. Improvement of type 2 diabetes mellitus (T2DM) after bariatric surgery—who fails in the early postoperative course? Obes Surg. 2012;22(10):1521–6.CrossRefPubMed Jurowich C, Thalheimer A, Hartmann D, et al. Improvement of type 2 diabetes mellitus (T2DM) after bariatric surgery—who fails in the early postoperative course? Obes Surg. 2012;22(10):1521–6.CrossRefPubMed
21.
go back to reference Lee MH, Lee W-J, Chong K, et al. Predictors of long-term diabetes remission after metabolic surgery. J Gastrointest Surg. 2015;19(6):1015–21.CrossRefPubMed Lee MH, Lee W-J, Chong K, et al. Predictors of long-term diabetes remission after metabolic surgery. J Gastrointest Surg. 2015;19(6):1015–21.CrossRefPubMed
22.
go back to reference Rosenthal R, Li X, Samuel S, et al. Effect of sleeve gastrectomy on patients with diabetes mellitus. Surg Obes Relat Dis. 2009;5(4):429–34.CrossRefPubMed Rosenthal R, Li X, Samuel S, et al. Effect of sleeve gastrectomy on patients with diabetes mellitus. Surg Obes Relat Dis. 2009;5(4):429–34.CrossRefPubMed
23.
go back to reference Robertson RP, Harmon J, Tran POT, et al. Beta-cell glucose toxicity, lipotoxicity, and chronic oxidative stress in type 2 diabetes. Diabetes. 2004;53(Suppl 1):S119–24.CrossRefPubMed Robertson RP, Harmon J, Tran POT, et al. Beta-cell glucose toxicity, lipotoxicity, and chronic oxidative stress in type 2 diabetes. Diabetes. 2004;53(Suppl 1):S119–24.CrossRefPubMed
24.
go back to reference Blackstone R, Bunt JC, Cortes 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.CrossRefPubMed Blackstone R, Bunt JC, Cortes 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.CrossRefPubMed
25.
go back to reference Jimenez 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.CrossRefPubMed Jimenez 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.CrossRefPubMed
26.
go back to reference Arterburn DE, Campos GM, Haneuse S, Sherwood NE, Bogart A, Sidney S, et al. The authors respond: a multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass obesity surgery. United States; 2013. 23, 1456–7. Arterburn DE, Campos GM, Haneuse S, Sherwood NE, Bogart A, Sidney S, et al. The authors respond: a multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass obesity surgery. United States; 2013. 23, 1456–7.
27.
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(7):910–6.CrossRefPubMed 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(7):910–6.CrossRefPubMed
28.
go back to reference English TM, Malkani S, Kinney RL, et al. Predicting remission of diabetes after RYGB surgery following intensive management to optimize preoperative glucose control. Obes Surg. 2015;25(1):1–6.CrossRefPubMed English TM, Malkani S, Kinney RL, et al. Predicting remission of diabetes after RYGB surgery following intensive management to optimize preoperative glucose control. Obes Surg. 2015;25(1):1–6.CrossRefPubMed
29.
go back to reference Lee W-J, Lee Y-C, Ser K-H, et al. Improvement of insulin resistance after obesity surgery: a comparison of gastric banding and bypass procedures. Obes Surg. 2008;18(9):1119–25.CrossRefPubMed Lee W-J, Lee Y-C, Ser K-H, et al. Improvement of insulin resistance after obesity surgery: a comparison of gastric banding and bypass procedures. Obes Surg. 2008;18(9):1119–25.CrossRefPubMed
30.
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(7):880–8.CrossRefPubMed 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(7):880–8.CrossRefPubMed
31.
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(9):E1372–9.CrossRefPubMed 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(9):E1372–9.CrossRefPubMed
32.
go back to reference Lee W-J, Almulaifi A, Tsou JJ, et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score. Surg Obes Relat Dis. 2015;11(5):991–6.CrossRefPubMed Lee W-J, Almulaifi A, Tsou JJ, et al. Laparoscopic sleeve gastrectomy for type 2 diabetes mellitus: predicting the success by ABCD score. Surg Obes Relat Dis. 2015;11(5):991–6.CrossRefPubMed
33.
go back to reference Huang C-K, Garg A, Kuao H-C, et al. Bariatric surgery in old age: a comparative study of laparoscopic roux-en-Y gastric bypass and sleeve gastrectomy in an Asia Centre of excellence. J Biomed Res. 2015;29(2):118–24.PubMedPubMedCentral Huang C-K, Garg A, Kuao H-C, et al. Bariatric surgery in old age: a comparative study of laparoscopic roux-en-Y gastric bypass and sleeve gastrectomy in an Asia Centre of excellence. J Biomed Res. 2015;29(2):118–24.PubMedPubMedCentral
34.
go back to reference Thereaux J, Corigliano N, Poitou C, et al. Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI >/= 50 kg/m(2). Surg Obes Relat Dis. 2015;11(4):785–90.CrossRefPubMed Thereaux J, Corigliano N, Poitou C, et al. Comparison of results after one year between sleeve gastrectomy and gastric bypass in patients with BMI >/= 50 kg/m(2). Surg Obes Relat Dis. 2015;11(4):785–90.CrossRefPubMed
Metadata
Title
Do Bariatric Surgery-Related Type 2 Diabetes Remission Predictors Add Clinical Value? A Study on Asian Indian Obese Diabetics
Authors
P. Praveen Raj
Siddhartha Bhattacharya
S. Saravana Kumar
Sandeep C. Sabnis
R. Parthasarathi
Parimala Devi Kumara Swamy
C. Palanivelu
Publication date
01-08-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 8/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2615-8

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