Roux-en-Y Gastric Bypass for T2D Treatment in Chinese Patients with Low BMI: 5-Year Outcomes
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ORIGINAL CONTRIBUTIONS
Roux-en-Y Gastric Bypass for T2D Treatment in Chinese Patients with Low BMI: 5-Year Outcomes Chen Wang 1 & Hongwei Zhang 1 & Haoyong Yu 2 & Yuqian Bao 2 & Pin Zhang 1 & Jianzhong Di 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background RYGB was considered as an effective treatment for obese patients with T2D. However, 5-year outcomes including T2D remission after surgery have not been adequately studied in Chinese patients. Objectives Our aim is to evaluate metabolic outcomes of RYGB in 5-year follow-up. Methods We retrospectively divided 59 Chinese patients into two groups, namely BMI groups (group A: BMI < 28 kg/m2; group B: BMI ≥ 28 kg/m2) and A1C groups (group C: A1C < 7%; group D: A1C ≥ 7%). Their medical records were collected and cardiovascular risk and medications were evaluated in 5 years after RYGB. Results Thirty patients were female (30/59, 50.85%). RYGB was performed laparoscopically without mortality or major complications. The mean BMI in 59 patients decreased from 30.89 ± 3.12 to 25.04 ± 3.48 in the fifth year. No one was lost to followup in 5 years. There were significant reductions in BMI, A1C, and oral medication or insulin in all groups. Diabetes remission rates in the first, third, and fifth years postoperation were 77.97, 61.02, and 49.15%. T2D relapse and requirement for antihypertensive agents increased in the third and fifth years. Larger quantity of subcutaneous fat area (SFA) and shorter duration of T2D preoperation were more likely to achieve remission of T2D postoperation. Conclusions This study has confirmed that RYGB is an effective treatment for obese Chinese patients with T2D, resulting in diabetes remission, metabolic disorder control, and cardiovascular risk reduction. Keywords Type 2 diabetes mellitus . Roux-en-Y gastric bypass . Obesity . Remission
Introduction Type 2 diabetes mellitus (T2D) is a life-threatening disease that is highly prevalent. The number of people with T2D is estimated to rise from 382 million in 2013 to 592 million by 2035 [1]. In addition to medical and exercise therapy, bariatric surgery has recently become a popular therapeutic approach for patients with T2D and obesity. Indeed, half a million bariatric surgery procedures are now performed annually worldwide, and Roux-en-Y gastric bypass (RYGB) is the frequently Chen Wang and Hongwei Zhang contributed equally to this work. * Jianzhong Di [email protected] 1
Department of Bariatric and Metabolic Surgery, Shanghai Jiao Tong University affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233, China
2
Department of Endocrinology, Shanghai Jiao Tong University affiliated Sixth People’s Hospital, 600 Yishan Road, Shanghai 200233, China
performed surgical procedure in recent years. A number of conditions, including essential hypertension, diabetes, asthma, osteoarthritis, and hyperlipidemia, can be ameliorated or even resolved following bariatric surgery [2]. Recent statements from the Diabetic Surgery Summit have indicated tha
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