title: Ten-year duration of type 2 diabetes as prognostic factor for remission after sleeve gastrectomy.
abstract: BACKGROUND
  Several studies have demonstrated a high rate of type 2 diabetes mellitus (T2DM) resolution after sleeve gastrectomy. Different prognostic factors have been hypothesized for T2DM remission after bariatric surgery. Our objectives were to analyze the role of T2DM duration as an independent prognostic factor for remission.
  
  
  METHODS
  From January 2008 to September 2010, 56 obese patients with T2DM underwent sleeve gastrectomy. Group A consisted of 16 patients who had lived with T2DM for >10 years (12 women and 4 men, mean body mass index 42.7 kg/m2). Group B included 40 obese patients who had lived with T2DM for <10 years (29 women and 11 men, mean body mass index 44.9 kg/m2).
  
  
  RESULTS
  In group A, 43.7% were treated with oral hypoglycemics, 6.3% with insulin, and 50% with oral hypoglycemics and insulin. In group B, 87.5% were treated with oral hypoglycemics, 5% with dietary therapy, and 7.5% with insulin. The preoperative average glycemia, glycosylated hemoglobin, and C-peptide value was 206.2 mg/dL, 9.5%, and 2.8 μg/L in group A and 134 mg/dL, 7.1%, and 4.5 μg/L in group B, respectively (P < .05 for all). The T2DM remission rate in all 56 patients was 80.3%. However, in group B, the resolution rate was 100%, but in group A, the resolution rate was 31%. Patients without complete remission were more sensitive to lower doses of antidiabetic drugs.
  
  
  CONCLUSIONS
  Sleeve gastrectomy is effective in the treatment of obese patients with T2DM. The duration of T2DM seems to be of paramount importance as a prognostic factor, with 10 years representing a cutoff between a 100% rate of remission and significantly lower rates of remission.
authors: Surgical-Medical Department for Digestive Diseases, Policlinico Umberto I, Sapienza University of Rome, Italy.
authors: Giovanni
authors: G
authors: Casella
authors: Francesca
authors: F
authors: Abbatini
authors: Benedetto
authors: B
authors: Calì
authors: Danila
authors: D
authors: Capoccia
authors: Frida
authors: F
authors: Leonetti
authors: Nicola
authors: N
authors: Basso
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012074:Remission Induction / Q000379:methods; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents