Background

Predictive parameters associated with type 2 diabetes mellitus (T2DM) remission following Roux-en-Y gastric bypass (RYGB) have not been well elucidated. We aim to report T2DM resolution rates and identify specific parameters associated with remission following RYGB.

Methods

We performed a multicenter retrospective study of patients who underwent RYGB between 2008-2017. Adult patients with diabetes who underwent RYGB were included. Patient demographics and clinical data were collected annually until 14 years after RYGB. T2DM remission was defined as HbA1c <6.5% and off anti-diabetes medications. Predictors were assessed using a multivariate logistic regression. Patients were divided into four groups based on their quartiles of total body weight loss percentage (%TBWL) to evaluate their T2DM remission rates. Data are summarized as mean± standard deviation.

Results

A total of 705 patients were included (66.5% female, age 52.4± 11.4 years; BMI 45.9± 7.9 kg/m2) with a mean follow-up period of 6.3± 3.9 years (Table 1). T2DM remission at last follow-up visit was demonstrated in 49% of patients (Figure 1A). Predictive factors of T2DM remission included pre-operative duration of T2DM (p<0.01), baseline HbA1c (p<0.01), insulin use prior to surgery (p<0.01), number of anti-diabetic medications (p=0.02) and total body weight loss percentage (p=0.01). Remission rates were proportional to %TBWL [Q1 40.3%, Q2 48.9%, Q3 51.1%, Q4 55.3%] (p=0.08) (Figure 1B).

Conclusions

Clinical and metabolic diabetes parameters as well as postoperative weight loss were associated with significant and sustained T2DM remission after RYGB. Regardless of weight loss, a significant proportion of patients will still experience diabetes remission.