Carranza-Leon BG, et al. - Researchers performed this retrospective study to assess the long-term remission rates of type 2 diabetes mellitus and correlated comorbidities after gastric bypass surgery in a complete cohort, in a real-life clinic setting. Significant and durable metabolic effects of gastric bypass were noted for at least 4 years, even in a predominantly male cohort and real-life clinical setting.

Methods

• The researchers conducted this study of all consecutive patients with type 2 diabetes mellitus who underwent gastric bypass at a Veterans Affairs Medical Center from 2003-2010.
• Remission of type 2 diabetes mellitus defined as HbA1c <6.5% (49 mmol/mol) without diabetic medication usage was the main outcome.
• Remission of hypertension and hyperlipidemia, weight loss, and long-term complications 4 years post-gastric bypass were included as secondary outcomes.

Results

• The researchers performed gastric bypass in 84 patients with type 2 diabetes mellitus.
• For 92% (77/84) of patients, 4-year follow-up data were available.
• The patients (73% male; mean age 54 years) had a mean body mass index of 49 kg/m² ± 8.3.
• The prevalence of hypertension and hyperlipidemia were 92% and 85%, respectively.
• Over 4 years, the mean total body weight decrease was 35 kg ± 21.
• They found remission of type 2 diabetes mellitus in 15% at 6 months and 49% at 4 years after surgery.
• Diabetes remission was more likely (OR 3.2; 95% confidence interval 1.2-9.7) in patients not using insulin at baseline.
• For hypertension, remission rates were 12% (9/74) and for hyperlipidemia it was noted to be 16% (11/68).
• Reoperation (11%), incisional hernia (10%) and anastomotic ulcer (10%) were included as long-term surgical complications.
• As per the outcomes, 44% of patients had 1 or more nutritional complications.