One Anastomosis Gastric Bypass for the Treatment of Type 2 Diabetes: Long-Term Results and Recurrence
Journal
Obesity Surgery
Journal Volume
31
Journal Issue
3
Pages
935-941
Date Issued
2021
Author(s)
Abstract
Background: Bariatric/metabolic surgery has been incorporated into the therapeutic treatment of type 2 diabetes mellitus (T2DM). Among many bariatric/metabolic procedures, one anastomosis gastric bypass (OAGB) is one of the most effective procedures but long-term data about T2DM recurrence after OAGB are lacking. Methods: Outcomes of 134 patients who had undergone OAGB for the treatment of T2DM with long-term (5?years) follow-up were assessed in a retrospective cohort study. The remission of T2DM after OAGB surgery was evaluated in different groups using a scoring system composed of the age, BMI, C-peptide level, duration of T2DM (ABCD score), and percent of total weight loss (%TWL). Results: The %TWL and percent of excess weight loss (%EWL) of the OAGB patients at 5?years after surgery were 29.2 (10.6) and 72.1(27.5), respectively. The mean BMI decreased from 39.5(7.9) to 27.6(5.3)?kg/m2 and mean glycated hemoglobin A1C (HbA1c) decreased from 8.9 to 5.9% in OAGB patients at 5?years after OAGB. The complete T2DM remission rate of OAGB was 76.1% at 1?year and 64.2% at 5?years after surgery. Forty-one (57.8%) out of 71 patients who completed a 10-year follow-up remained in complete T2DM remission. The T2DM recurrence rate of OAGB patients was 15.7% at 5?years after surgery. Conclusions: OAGB is highly effective in inducing T2DM remission but a significant number of patients will still have T2DM recurrence. To select patient with an ABCD score >?5 and maintaining a weight loss greater than 30% is important for durable T2DM remission after OAGB. ? 2020, Springer Science+Business Media, LLC, part of Springer Nature.
Subjects
C peptide; hemoglobin A1c; ABCD2 score; adult; age; Article; body mass; body weight loss; cohort analysis; controlled study; disease duration; female; follow up; gastric bypass surgery; glycemic control; human; major clinical study; male; non insulin dependent diabetes mellitus; one anastomosis gastric bypass; priority journal; recurrence risk; recurrent disease; remission; retrospective study; treatment outcome; morbid obesity; treatment outcome; Diabetes Mellitus, Type 2; Gastric Bypass; Humans; Obesity, Morbid; Retrospective Studies; Treatment Outcome; Weight Loss
SDGs
Type
journal article