Background: Several studies have demonstrated a high rate of type 2 diabetes mellitus (T2DM) resolution after sleeve gastrectomy. Different prognostic factors have been hypothesized for T2DM remission after bariatric surgery. Our objectives were to analyze the role of T2DM duration as an independent prognostic factor for remission. Methods: From January 2008 to September 2010, 56 obese patients with T2DM underwent sleeve gastrectomy. Group A consisted of 16 patients who had lived with T2DM for >10 years (12 women and 4 men, mean body mass index 42.7 kg/m(2)). Group B included 40 obese patients who had lived with T2DM for <10 years (29 women and 11 men, mean body mass index 44.9 kg/m(2)). Results: In group A, 43.7% were treated with oral hypoglycemics, 6.3% with insulin, and 50% with oral hypoglycemics and insulin. In group B, 87.5% were treated with oral hypoglycemics, 5% with dietary therapy, and 7.5% with insulin. The preoperative average glycemia, glycosylated hemoglobin, and C-peptide value was 206.2 mg/dL, 9.5%, and 2.8 mu g/L in group A and 134 mg/dL, 7.1%, and 4.5 mu g/L in group B, respectively (P < .05 for all). The T2DM remission rate in all 56 patients was 80.3%. However, in group B, the resolution rate was 100%, but in group A, the resolution rate was 31%. Patients without complete remission were more sensitive to lower doses of antidiabetic drugs. Conclusion: Sleeve gastrectomy is effective in the treatment of obese patients with T2DM. The duration of T2DM seems to be of paramount importance as a prognostic factor, with 10 years representing a cutoff between a 100% rate of remission and significantly lower rates of remission. (Surg Obes Relat Dis 2011;7:697-702.) (C) 2011 American Society for Metabolic and Bariatric Surgery. All rights reserved.

Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy / Casella, Giovanni; Abbatini, Francesca; Benedetto, Cali; Capoccia, Danila; Leonetti, Frida; Basso, Nicola. - In: SURGERY FOR OBESITY AND RELATED DISEASES. - ISSN 1550-7289. - STAMPA. - 7:6(2011), pp. 697-702. [10.1016/j.soard.2011.08.014]

Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy

CASELLA, GIOVANNI;Francesca Abbatini;CAPOCCIA, DANILA;LEONETTI, Frida;BASSO, Nicola
2011

Abstract

Background: Several studies have demonstrated a high rate of type 2 diabetes mellitus (T2DM) resolution after sleeve gastrectomy. Different prognostic factors have been hypothesized for T2DM remission after bariatric surgery. Our objectives were to analyze the role of T2DM duration as an independent prognostic factor for remission. Methods: From January 2008 to September 2010, 56 obese patients with T2DM underwent sleeve gastrectomy. Group A consisted of 16 patients who had lived with T2DM for >10 years (12 women and 4 men, mean body mass index 42.7 kg/m(2)). Group B included 40 obese patients who had lived with T2DM for <10 years (29 women and 11 men, mean body mass index 44.9 kg/m(2)). Results: In group A, 43.7% were treated with oral hypoglycemics, 6.3% with insulin, and 50% with oral hypoglycemics and insulin. In group B, 87.5% were treated with oral hypoglycemics, 5% with dietary therapy, and 7.5% with insulin. The preoperative average glycemia, glycosylated hemoglobin, and C-peptide value was 206.2 mg/dL, 9.5%, and 2.8 mu g/L in group A and 134 mg/dL, 7.1%, and 4.5 mu g/L in group B, respectively (P < .05 for all). The T2DM remission rate in all 56 patients was 80.3%. However, in group B, the resolution rate was 100%, but in group A, the resolution rate was 31%. Patients without complete remission were more sensitive to lower doses of antidiabetic drugs. Conclusion: Sleeve gastrectomy is effective in the treatment of obese patients with T2DM. The duration of T2DM seems to be of paramount importance as a prognostic factor, with 10 years representing a cutoff between a 100% rate of remission and significantly lower rates of remission. (Surg Obes Relat Dis 2011;7:697-702.) (C) 2011 American Society for Metabolic and Bariatric Surgery. All rights reserved.
2011
bariatric surgery; diabetes mellitus; metabolic surgery; prognostic factors; sleeve gastrectomy
01 Pubblicazione su rivista::01a Articolo in rivista
Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy / Casella, Giovanni; Abbatini, Francesca; Benedetto, Cali; Capoccia, Danila; Leonetti, Frida; Basso, Nicola. - In: SURGERY FOR OBESITY AND RELATED DISEASES. - ISSN 1550-7289. - STAMPA. - 7:6(2011), pp. 697-702. [10.1016/j.soard.2011.08.014]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/443600
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