T2DM Initially Remits in Majority Who Undergo Gastric Bypass
Roux-en-Y gastric bypass linked to significantly lower risk for microvascular complications
(HealthDay News) -- Roux-en-Y gastric bypass (RYGB) is associated with high levels of type 2 diabetes remission at 1 year, although 27% relapse after 5 years, according to a study published online in Diabetologia.
Lene R. Madsen, from Aarhus University Hospital in Denmark, and colleagues conducted a population-based study of 1111 individuals with type 2 diabetes and obesity treated by RYGB from 2006 to 2015 and 1074 matched individuals with type 2 diabetes who did not undergo surgery.
The researchers found that 74% of the RYGB cohort experienced diabetes remission at 1-year follow-up; after 5 years, 27% had relapsed. Age >50 years, diabetes duration longer than 5 years, use of glucose-lowering drugs other than metformin, and baseline hemoglobin A1c >7.0% were predictors of nonremission. The RYGB cohort had a significantly lower risk for microvascular complications (hazard ratio, 0.53; 95% confidence interval, 0.38 to 0.73) and a statistically nonsignificant lower risk for macrovascular complications (hazard ratio, 0.76; 95% confidence interval, 0.49 to 1.18) compared with the nonsurgical cohort. At 1 year, diabetes remission vs nonremission correlated with a significantly reduced risk for microvascular complications (hazard ratio, 0.43; 95% confidence interval, 0.25 to 0.72) and a nonsignificantly reduced risk for macrovascular complications (hazard ratio, 0.76; 95% confidence interval, 0.40 to 1.45).
"RYGB does remit type 2 diabetes and is associated with a reduced risk of microvascular, and possibly macrovascular, complications," the authors write.
The study was partially funded by the Novo Nordisk Foundation.
Madsen LR, Baggesen LM, Richelsen B, Thomsen RW. Effect of Roux-en-Y gastric bypass surgery on diabetes remission and complications in individuals with type 2 diabetes: a Danish population-based matched cohort study. Diabetologia. DOI:10.1007/s00125-019-4816-2