One Anastomosis Gastric Bypass for the Treatment of Type 2 Diabetes: Long-Term Results and Recurrence
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ORIGINAL CONTRIBUTIONS
One Anastomosis Gastric Bypass for the Treatment of Type 2 Diabetes: Long-Term Results and Recurrence Tien-Chou Soong 1,2,3 & Ming-Hsien Lee 4 & Wei-Jei Lee 2,5
&
Jung-Chien Chen 5 & Chun-Chi Wu 5 & Shu-Chun Chun 5
Received: 7 August 2020 / Revised: 24 October 2020 / Accepted: 26 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords One anastomosis gastric bypass . T2DM . ABCD score . Weight loss . Diabetes recurrence
Introduction The rapid increase in obesity and type 2 diabetes mellitus (T2DM) worldwide is becoming one of the major global health threats of our time. It has been estimated that 463 million people are living with T2DM in 2020 [1]. Unfortunately, current
* Wei-Jei Lee [email protected] 1
Center of Weight Loss and Health Management, E-DA Dachang Hospital, Kaohsiung, Taiwan
2
Department of Asia Obesity Medical Research Center, E-DA Hospital, Kaohsiung, Taiwan
3
College of Medicine, I-Shou University, Kaohsiung, Taiwan
4
Metabolic & Bariatric Surgical Department, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
5
Department of Surgery, Min-Sheng General Hospital, No. 168, Chin Kuo Road, Tauoyan, Taiwan, Republic of China
medical treatment has been relatively unsatisfactory, as more than half of patients cannot achieve the therapeutic goal [2, 3]. Because bariatric surgery has been shown to be very successful in treating morbid obesity and ob
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