Minimum Threshold of Bariatric Surgical Weight Loss for Initial Diabetes Remission
| Autor: | Benjamin Kim, Peter N. Fedorka, David Arterburn, Douglas Barthold, Sameer B. Murali, Elizabeth Brouwer, Cecelia L. Crawford, Tae K. Yoon, Karen J. Coleman, Anirban Basu, Kristi Reynolds, Lee J Barton, Heidi Fischer, Anita P. Courcoulas, Robert Zane, Edward Mun |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Sleeve gastrectomy medicine.medical_specialty Endocrinology Diabetes and Metabolism medicine.medical_treatment Gastric bypass Gastric Bypass Bariatric Surgery Weight loss Gastrectomy Diabetes mellitus Weight Loss Internal Medicine medicine Humans Epidemiology/Health Services Research Retrospective Studies Advanced and Specialized Nursing business.industry Proportional hazards model Remission Induction Hazard ratio Type 2 Diabetes Mellitus Mean age Middle Aged medicine.disease Surgery Obesity Morbid Treatment Outcome Diabetes Mellitus Type 2 Female medicine.symptom business |
| Zdroj: | Diabetes Care |
| Popis: | OBJECTIVE There are few studies testing the amount of weight loss necessary to achieve initial remission of type 2 diabetes mellitus (T2DM) following bariatric surgery and no published studies with use of weight loss to predict initial T2DM remission in sleeve gastrectomy (SG) patients. RESEARCH DESIGN AND METHODS With Cox proportional hazards models we examined the relationship between initial T2DM remission and percent total weight loss (%TWL) after bariatric surgery. Categories of %TWL were included in the model as time-varying covariates. RESULTS Of patients (N = 5,928), 73% were female; mean age was 49.8 ± 10.3 years and BMI 43.8 ± 6.92 kg/m2, and 57% had Roux-en-Y gastric bypass (RYGB). Over an average follow-up of 5.9 years, 71% of patients experienced initial remission of T2DM (mean time to remission 1.0 year). With 0–5% TWL used as the reference group in Cox proportional hazards models, patients were more likely to remit with each 5% increase in TWL until 20% TWL (hazard ratio range 1.97–2.92). When categories >25% TWL were examined, all patients had a likelihood of initial remission similar to that of 20–25% TWL. Patients who achieved >20% TWL were more likely to achieve initial T2DM remission than patients with 0–5% TWL, even if they were using insulin at the time of surgery. CONCLUSIONS Weight loss after bariatric surgery is strongly associated with initial T2DM remission; however, above a threshold of 20% TWL, rates of initial T2DM remission did not increase substantially. Achieving this threshold is also associated with initial remission even in patients who traditionally experience lower rates of remission, such as patients taking insulin. |
| Databáze: | OpenAIRE |
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