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Diabetes remission after malabsorptive bariatric surgery
Elena González Arnáiz1, María D Ballesteros Pomar2, Begoña Pintor de la Maza2
1Sección de Endocrinología y Nutrición. Complejo Asistencial Universitario de León, León, España; Servicio de Cirugía General y del Aparato Digestivo. Complejo Asistencial Universitario de León, León, España.
Endocrinologia, Diabetes Y Nutricion
|January 26, 2021
Summary
Bariatric surgery, especially malabsorptive procedures like biliopancreatic diversion, effectively achieves long-term diabetes remission and weight loss in obese patients with type 2 diabetes.
Area of Science:
- Metabolic Surgery
- Endocrinology
- Bariatric Surgery
Background:
- Obesity and type 2 diabetes mellitus (T2DM) are linked, with limited success in remission via lifestyle or medication.
- Bariatric surgery (BS) offers a potential treatment option for T2DM remission in obese individuals.
Purpose of the Study:
- To evaluate the one- and five-year efficacy of BS, specifically biliopancreatic diversion (BPD), for weight reduction and T2DM remission.
- To assess diabetes remission (DR) rates using ADA criteria and compare the predictive accuracy of DR scoring systems.
- To identify predictors of DR following BPD at one and five years.
Main Methods:
- Prospective study evaluating patients with obesity and T2DM undergoing BPD.
- Assessment of weight, blood glucose, HbA1c, and DR rates (ADA criteria) at 1 and 5 years post-surgery.
- Analysis of DR predictive scores (DiaRem, Ad-DiaRem, 5y-Ad-DiaRem) and pre-surgery variables.
Main Results:
- BPD demonstrated significant overweight reduction and improvements in blood glucose and HbA1c levels.
- Approximately 80% of patients achieved complete diabetes remission at both one and five years post-BPD.
- Predictive scores showed limited discriminative capacity for DR in malabsorptive surgery; pre-surgery HbA1c was a significant predictor of DR.
Conclusions:
- Biliopancreatic diversion is highly effective for achieving sustained weight loss and diabetes remission in patients with obesity and T2DM.
- Individualized surgical approach is recommended, considering diabetes severity and patient-specific factors.
- Pre-surgery HbA1c is a key predictor for long-term diabetes remission following malabsorptive bariatric surgery.
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