title: Defining and predicting complete remission of type 2 diabetes: a short-term efficacy study of open gastric bypass.
abstract: OBJECTIVE
  To investigate the metabolic effects of open Roux-en Y gastric bypass (RYGB) on pancreatic endocrine reserve in overweight/obese Chinese patients with type 2 diabetes during postoperative year 1.
  
  
  METHODS
  Retrospective analysis comparing pre- and postoperative results of oral glucose tolerance tests (OGTT) with determinations of insulin and C-peptide, glycated hemoglobin (HbA1c), insulin resistance (HOMA-IR), and BMI at 1, 3, 6, and 12 months in 99 overweight patients (BMI 26.3 ± 4.0 kg/m(2); 59 men) with type 2 diabetes at the General Hospital of Chengdu Military Region.
  
  
  RESULTS
  79 patients (80%) achieved complete remission (maintaining random blood glucose levels < 11.1 mmol/l, fasting blood glucose levels < 7.0 mmol/l, 2-hour OGTT blood glucose levels < 11.1 mmol/l, and glycated hemoglobin < 6.5%). Nine cases (9%) were 'improved' (reduced medication or diet controlled blood sugar), and 11 cases did not meet either criterion ('unchanged'). Patients in complete remission were younger and heavier, more often men, had significantly shorter history of diabetes (4.3 ± 3.8 years vs. 7.6 ± 3.8 years, p < 0.05), and exhibited significantly higher fasting and OGTT levels of C-peptide and insulin, and HOMA-IR than the other 2 groups (p < 0.05-0.01).
  
  
  CONCLUSIONS
  Open gastric bypass achieved complete remission of type 2 diabetes in Chinese overweight/obese, heavier, younger, predominantly male patients with shorter duration of disease exhibiting greater pancreatic endocrine reserve.
authors.affiliation: General Surgery Center of PLA, Chengdu Military General Hospital, Chengdu, China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Yan
authors.forename: Lijun
authors.initials: L
authors.lastname: Tang
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.forename: John G
authors.initials: JG
authors.lastname: Kral
authors.forename: Li
authors.initials: L
authors.lastname: Jiang
authors.forename: Yunming
authors.initials: Y
authors.lastname: Li
authors.forename: Ruidong
authors.initials: R
authors.lastname: Hu
authors.forename: Jiangfeng
authors.initials: J
authors.lastname: Cui
authors.forename: Shi
authors.initials: S
authors.lastname: Li
authors.forename: Fuzhou
authors.initials: F
authors.lastname: Tian
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D002097:C-Reactive Protein / Q000378:metabolism; D002681:China; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D005215:Fasting; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery*; D012074:Remission Induction; D012737:Sex Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin; D007328:Insulin