Skip to main content
Top
Published in: BMC Surgery 1/2013

Open Access 01-12-2013 | Research article

Which criteria should be used to define type 2 diabetes remission after bariatric surgery?

Authors: Ana M Ramos-Levi, Lucio Cabrerizo, Pilar Matía, Andrés Sánchez-Pernaute, Antonio J Torres, Miguel A Rubio

Published in: BMC Surgery | Issue 1/2013

Login to get access

Abstract

Background

Comparison of diabetes remission rates after bariatric surgery using two different models of criteria.

Methods

Retrospective analysis of data from 110 patients with type 2 diabetes and morbid obesity who underwent bariatric surgery, preoperatively and at 18-month follow-up. Comparison of two models of remission: 1) 2009 consensus statement criteria; 2) simple criteria using ADA’s HbA1c diabetes diagnostic cut-off values.

Results

Patients’ mean ± SD preoperative characteristics were: age 53.3 ± 9.5 years, BMI 43.6 ± 5.5 kg/m2, HbA1c 7.9 ± 1.8%, duration of diabetes 7.6 ± 7.5 years. 44.5% of patients with previous insulin therapy. With 2009 consensus statement criteria: complete, partial and no remission in 50%, 12.7% and 37.3%, respectively; with HbA1c criteria: 50%, 15% and 34.5% in the analogous categories (p = 0.673).

Conclusions

We suggest a simpler approach to evaluate diabetes remission after bariatric surgery, following the rationale of the definition of diabetes itself.
Appendix
Available only for authorised users
Literature
2.
go back to reference American Diabetes Association: Standards of Medical Care in Diabetes 2012. Diabetes Care. 2012, 35: S11-S63.CrossRef American Diabetes Association: Standards of Medical Care in Diabetes 2012. Diabetes Care. 2012, 35: S11-S63.CrossRef
3.
go back to reference Pournaras DJ, Aasheim ET, Søvik TT: Effect of the definition of type II diabetes remission in the evaluation of bariatric surgery for metabolic disorders. Br J Surg. 2012, 99: 100-3. 10.1002/bjs.7704.CrossRefPubMed Pournaras DJ, Aasheim ET, Søvik TT: Effect of the definition of type II diabetes remission in the evaluation of bariatric surgery for metabolic disorders. Br J Surg. 2012, 99: 100-3. 10.1002/bjs.7704.CrossRefPubMed
4.
go back to reference Buchwald H, Estok R, Fahrbach K: Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009, 122: 248-256. 10.1016/j.amjmed.2008.09.041. e5CrossRefPubMed Buchwald H, Estok R, Fahrbach K: Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009, 122: 248-256. 10.1016/j.amjmed.2008.09.041. e5CrossRefPubMed
5.
go back to reference Dixon JB, le Roux CW, Rubino F, Zimmet P: Bariatric Surgery for type 2 diabetes. Lancet. 2012, 16 (379): 2300-2311.CrossRef Dixon JB, le Roux CW, Rubino F, Zimmet P: Bariatric Surgery for type 2 diabetes. Lancet. 2012, 16 (379): 2300-2311.CrossRef
6.
go back to reference Mingrone G, Panunzi S, De Gaetano A: Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012, 366: 1577-1585. 10.1056/NEJMoa1200111.CrossRefPubMed Mingrone G, Panunzi S, De Gaetano A: Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med. 2012, 366: 1577-1585. 10.1056/NEJMoa1200111.CrossRefPubMed
7.
go back to reference Schauer P, Kashyap SR, Wolski K: Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012, 366: 1567-1576. 10.1056/NEJMoa1200225.CrossRefPubMedPubMedCentral Schauer P, Kashyap SR, Wolski K: Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012, 366: 1567-1576. 10.1056/NEJMoa1200225.CrossRefPubMedPubMedCentral
8.
go back to reference Blackstone R, Bunt JC, Cortés MC, Sugerman HJ: Type 2 diabetes after gastric bypass: remission in five models using HbA1c, fasting blood glucose, and medication status. Surg Obes Relat Dis. 2012, 8: 548-55. 10.1016/j.soard.2012.05.005.CrossRefPubMed Blackstone R, Bunt JC, Cortés MC, Sugerman HJ: Type 2 diabetes after gastric bypass: remission in five models using HbA1c, fasting blood glucose, and medication status. Surg Obes Relat Dis. 2012, 8: 548-55. 10.1016/j.soard.2012.05.005.CrossRefPubMed
9.
go back to reference Schernthaner G, Brix JM, Kopp HP, Schernthaner GH: Cure of type 2 diabetes by metabolic surgery? A critical analysis of the evidence in 2010. Diabetes Care. 2011, 34 (Suppl 2): S355-360.CrossRefPubMedPubMedCentral Schernthaner G, Brix JM, Kopp HP, Schernthaner GH: Cure of type 2 diabetes by metabolic surgery? A critical analysis of the evidence in 2010. Diabetes Care. 2011, 34 (Suppl 2): S355-360.CrossRefPubMedPubMedCentral
10.
go back to reference Kashyap SR, Schauer P: Clinical considerations for the management of residual diabetes following bariatric surgery. Diabetes Obes Metab. 2012, 14: 733-779.CrossRef Kashyap SR, Schauer P: Clinical considerations for the management of residual diabetes following bariatric surgery. Diabetes Obes Metab. 2012, 14: 733-779.CrossRef
11.
go back to reference Schauer PR, Burguera B, Ikramuddin S: Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003, 238: 467-485.PubMedPubMedCentral Schauer PR, Burguera B, Ikramuddin S: Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003, 238: 467-485.PubMedPubMedCentral
12.
go back to reference Dixon JB, O’Brien PR, Playfair J: Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008, 299: 316-323. 10.1001/jama.299.3.316.PubMed Dixon JB, O’Brien PR, Playfair J: Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA. 2008, 299: 316-323. 10.1001/jama.299.3.316.PubMed
13.
go back to reference Vetter ML, Cardillo S, Rickels MR, Iqbal N: Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Ann Intern Med. 2009, 150: 94-103.CrossRefPubMed Vetter ML, Cardillo S, Rickels MR, Iqbal N: Narrative review: effect of bariatric surgery on type 2 diabetes mellitus. Ann Intern Med. 2009, 150: 94-103.CrossRefPubMed
14.
go back to reference Hamza N, Abbas MH, Darwish A, Shafeek Z, New J, Ammori BJ: Predictors of remission of type 2 diabetes mellitus after laparoscopic gastric banding and bypass. Surg Obes Relat Dis. 2011, 7: 691-6. 10.1016/j.soard.2010.03.292.CrossRefPubMed Hamza N, Abbas MH, Darwish A, Shafeek Z, New J, Ammori BJ: Predictors of remission of type 2 diabetes mellitus after laparoscopic gastric banding and bypass. Surg Obes Relat Dis. 2011, 7: 691-6. 10.1016/j.soard.2010.03.292.CrossRefPubMed
Metadata
Title
Which criteria should be used to define type 2 diabetes remission after bariatric surgery?
Authors
Ana M Ramos-Levi
Lucio Cabrerizo
Pilar Matía
Andrés Sánchez-Pernaute
Antonio J Torres
Miguel A Rubio
Publication date
01-12-2013
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2013
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/1471-2482-13-8

Other articles of this Issue 1/2013

BMC Surgery 1/2013 Go to the issue