Comparative Effectiveness of Roux-en Y Gastric Bypass Versus Vertical Sleeve Gastrectomy for Sustained Remission of Type 2 Diabetes Mellitus
| Autor: | Joseph K. Canner, Kimberley E. Steele, Richard D. Nudotor, Aldo G. Gonzalez, Enoch J. Abbey, Gregory Prokopowicz |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Sleeve gastrectomy medicine.medical_treatment Gastric bypass Gastric Bypass Charlson index 03 medical and health sciences 0302 clinical medicine Gastrectomy Internal medicine medicine Humans Obesity Aged Retrospective Studies business.industry Remission Induction nutritional and metabolic diseases Type 2 Diabetes Mellitus Retrospective cohort study Middle Aged Roux-en-Y anastomosis Treatment Outcome Diabetes Mellitus Type 2 030220 oncology & carcinogenesis Cohort 030211 gastroenterology & hepatology Surgery Female Sustained remission business |
| Zdroj: | The Journal of surgical research. 261 |
| ISSN: | 1095-8673 |
| Popis: | Background Bariatric surgery results in rapid weight loss and resolution of comorbidities such as type 2 diabetes mellitus (T2DM). We aimed to determine whether the type of surgical procedure—vertical sleeve gastrectomy (VSG) versus Roux-en-Y gastric bypass (RYGB)—was associated with sustained remission from T2DM, and to identify other independent predictors of sustained remission. Methods Using the IBM MarketScan database of privately insured patients in the United States, we performed a retrospective cohort study on individuals aged 18-65 y with T2DM on hypoglycemic medication, who underwent either VSG or RYGB from 2010 to 2016. Remission was defined as no refill of antidiabetic medication 180 d after a patient's medication was expected to run out and recurrence as medication refill after at least 180 d of remission. Results Of 5119 patients in our cohort, 4127 (81%) experienced remission of T2DM, and 816 (19.8%) of the 4127 patients experienced recurrence. Patients who underwent RYGB had a 24% (HR = 1.24, 95% CI: 1.16, 1.32) increased probability of achieving remission compared with VSG. RYGB had a 36% (HR = 0.64, 95% CI: 0.55, 0.74) decreased risk of recurrence compared with VSG. A higher number of diabetic medications at the time of surgery and a higher Charlson index score were associated with decreased probability of remission and an increased risk of recurrence of T2DM. Conclusions While both procedures are initially effective, RYGB may be better than VSG at providing lasting remission of T2DM. |
| Databáze: | OpenAIRE |
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