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New Metrics to Assess Type 2 Diabetes After Bariatric Surgery: The "Time-Within-Remission Range".


ABSTRACT: Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the "time-within-remission range" as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 ± 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, "time-within-remission range" and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 ± 9.2 years old, body mass index (BMI) 46.3 ± 6.9 kg/m2) underwent primary bariatric procedures. "Time-within-remission range" were 83.3% (33.3-91.6) after gastric bypass, 68.7% (7.1-87.5) after sleeve gastrectomy and 90% (83.3-92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the "time-within-remission range". The association of bariatric techniques with "time-within-remission range", using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34-5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40-0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The "time-within-remission range" unveils a superiority of gastric bypass compared to sleeve gastrectomy.

SUBMITTER: Hollanda A 

PROVIDER: S-EPMC7230819 | biostudies-literature | 2020 Apr

REPOSITORIES: biostudies-literature

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New Metrics to Assess Type 2 Diabetes After Bariatric Surgery: The "Time-Within-Remission Range".

Hollanda Ana de A   Lecube Albert A   Rubio Miguel Angel MA   Sánchez Enric E   Vilarrasa Núria N   Oliva José Gregorio JG   Fernández-Soto María Luisa ML   Salas-Salvadó Jordi J   Ballesteros-Pomar María D MD   Ciudin Andreea A   Torres Ferran F   Vidal Concepción C   Morales María José MJ   Valdés Sergio S   Pellitero Silvia S   Miñambres Inka I   Masmiquel Lluís L   Goday Albert A   Suarez Lorena L   Flores Liliam L   Bueno Marta M   Caixàs Assumpta A   Bretón Irene I   Cámara Rosa R   Olbeyra Romina R   Penso Rona R   José de la Cruz María M   Simó-Servat Andreu A   Pereyra-García Francisca María FM   López-Mezquita Elena Teresa ET   Gils Anna A   Fidilio Enzamaria E   Bandrés Orosia O   Martínez Ángel Á   Abuín Jose J   Marques-Pamies Montserrat M   Tuneu Laura L   Arteaga Magdalena M   Castañer Olga O   Goñi Fernando F   Arrizabalaga Cristina C   Botana Manuel Antonio MA   Calañas Alfonso A   Rebollo Ángel Á  

Journal of clinical medicine 20200409 4


Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the "time-within-remission range" as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with  ...[more]

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