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ABSTRACT: Background
The purpose of this study is to compare effects of different nations on Roux-en-Y gastric bypass (RYGB) vs. intensive medical management (IMM) in achieving remission of type 2 diabetes mellitus (T2DM).Materials and methods
Between April 2008 and December 2011, this randomized, controlled clinical trial was conducted at four teaching hospitals in the United States and Taiwan involving 71 participants with mild obesity (BMI 30-35 kg/m2). Thirty-six of 71 participants were randomly assigned to the RYGB group, and the others were in IMM group. Partial or complete remission of T2DM was defined as blood HbA1c < 6.5 % (48 mmol/mol) or <6 % (42 mmol/mol) without any antihyperglycemic medication for at least 1-year duration, respectively.Results
At baseline, Taiwanese participants had a lower BMI, younger age, and shorter duration of T2DM than American participants. At 24 months, weight loss was greater in the RYGB group in both populations than in the IMM group. No IMM participant of either population had partial or complete remission of T2DM. In the RYGB group, a substantial proportion of the subjects achieved complete or partial remission (57 % in Taiwanese and 27 % in American participants, P = 0.08). Logistic regression revealed stimulated C-peptide (Odds ratio 2.22, P = 0.02) but not nationality as a significant predictor of diabetes remission.Conclusion
Adding RYGB to lifestyle and medical management was associated with a greater likelihood of remission of T2DM in both Taiwanese and American subjects with mild obesity with type 2 diabetes. Residual beta-cell function at baseline appears to be the major factor predicting remission of T2DM. Trial registry number: clinicaltrials.gov Identifier: NCT00641251.
SUBMITTER: Chong K
PROVIDER: S-EPMC5403871 | biostudies-literature | 2017 May
REPOSITORIES: biostudies-literature
Chong Keong K Ikramuddin Sayeed S Lee Wei-Jei WJ Billington Charles J CJ Bantle John P JP Wang Qi Q Thomas Avis J AJ Connett John E JE Leslie Daniel B DB Inabnet William B WB Jeffery Robert W RW Sarr Michael G MG Jensen Michael D MD Vella Adrian A Ahmed Leaque L Belani Kumar K Schone Joyce L JL Olofson Amy E AE Bainbridge Heather A HA Laqua Patricia S PS Korner Judith J Chuang Lee-Ming LM
Obesity surgery 20170501 5
<h4>Background</h4>The purpose of this study is to compare effects of different nations on Roux-en-Y gastric bypass (RYGB) vs. intensive medical management (IMM) in achieving remission of type 2 diabetes mellitus (T2DM).<h4>Materials and methods</h4>Between April 2008 and December 2011, this randomized, controlled clinical trial was conducted at four teaching hospitals in the United States and Taiwan involving 71 participants with mild obesity (BMI 30-35 kg/m<sup>2</sup>). Thirty-six of 71 parti ...[more]