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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, Spain; Servicio de Cirugía General y del Aparato Digestivo, Complejo Asistencial Universitario de León, León, Spain.
Endocrinologia, Diabetes Y Nutricion
|July 16, 2021
Summary
Bariatric surgery, particularly malabsorptive procedures like biliopancreatic diversion, effectively achieves diabetes remission (DR) and weight loss in obese patients with type 2 diabetes. Pre-surgery HbA1c is a key predictor of long-term DR.
Area of Science:
- Metabolic Surgery
- Endocrinology
- Bariatric Surgery
Background:
- Obesity and type 2 diabetes are linked, with limited success in remission via lifestyle or drug interventions.
- Bariatric surgery (BS) offers a treatment option, with malabsorptive techniques showing higher efficacy for weight reduction and diabetes remission (DR).
Purpose of the Study:
- To evaluate the 1- and 5-year benefits of BS on weight and glycemic control in obese patients with type 2 diabetes.
- To assess diabetes remission rates using ADA criteria and the predictive capacity of various scores.
- To identify predictors of DR after biliopancreatic diversion (BPD).
Main Methods:
- Prospective study evaluating patients undergoing BPD.
- Assessment of weight reduction, blood glucose, HbA1c, and diabetes remission rates at 1 and 5 years post-surgery.
- Analysis of the predictive performance of DiaRem, Ad-DiaRem, and 5y-Ad-DiaRem scores.
- Identification of variables predicting DR.
Main Results:
- Biliopancreatic diversion (BPD) resulted in significant overweight reduction and improved blood glucose and HbA1c levels.
- Complete diabetes remission rates were approximately 80% at both 1 and 5 years post-BS.
- Predictive scores demonstrated poor discriminative capacity for DR in malabsorptive surgery.
- Pre-surgery HbA1c was a significant predictor of DR at 1 and 5 years after BPD.
Conclusions:
- Biliopancreatic diversion is highly effective for achieving long-term diabetes remission and weight loss in patients with obesity and type 2 diabetes.
- Individualized surgical approach is recommended, considering diabetes severity and patient characteristics.
- Pre-surgery HbA1c is a valuable predictor for long-term diabetes remission after malabsorptive bariatric surgery.
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