title: Metabolic outcomes 2 years following gastric bypass surgery in people with type 2 diabetes: an observational cohort study.
abstract: BACKGROUND
  Gastric bypass surgery induces early remission or significant improvement in type 2 diabetes (T2D).
  
  
  OBJECTIVE
  To assess effectiveness of stopping glucose-lowering treatment at the time of surgery.
  
  
  METHODS
  Observational cohort analysis.
  
  
  METHODS
  We identified 101 patients (62 women) with T2D who had undergone gastric bypass surgery at a mean (SD, standard deviation) age of 51.4 (9.0) years. We recorded weight, body mass index (BMI), glycosylated haemoglobin (HbA1c), blood pressure (BP), total and high-density lipoprotein (HDL) cholesterol preoperatively and at a median 4, 12 and 24 months postoperatively, and changes to glucose-lowering therapy.
  
  
  RESULTS
  Mean (SD) baseline BMI was 50.3 (6.3) kg/m(2), HbA1c 65.3 (18.5) mmol/mol, systolic BP 146.0 (18.0) mmHg, diastolic BP 87.0 (10.8) mmHg and total cholesterol-to-HDL cholesterol ratio 4.0 (1.2). Mean (95% confidence interval) reduction in BMI was 16.4 (14.1-18.7) kg/m(2), HbA1c 23.6 (17.6-29.6) mmol/mol, systolic BP 12.9 (5.9-19.8) mmHg, diastolic BP 6.1 (1.8-10.5) mmHg and total cholesterol-to-HDL cholesterol ratio 1.1 (0.6-1.5) at 24 months (P < 0.001 for all measures). Although 91% of patients were receiving glucose-lowering therapies preoperatively, complete (HbA1c < 42 mmol/mol) and partial (HbA1c 42-48 mmol/mol) remissions of T2D were seen in 62.1% and 5.2% at 2 years postoperatively.
  
  
  CONCLUSIONS
  Cessation of glucose-lowering therapies in people with T2D at the time of gastric bypass surgery was clinically effective. The majority of patients remained in complete or partial remission of diabetes up to 2 years postoperatively.
authors.affiliation: From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK.
authors.forename: F
authors.initials: F
authors.lastname: Behbehani
authors.affiliation: From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK.
authors.forename: B J
authors.initials: BJ
authors.lastname: Ammori
authors.affiliation: From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK.
authors.forename: J P
authors.initials: JP
authors.lastname: New
authors.affiliation: From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK.
authors.forename: L K M
authors.initials: LK
authors.lastname: Summers
authors.affiliation: From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK.
authors.forename: H
authors.initials: H
authors.lastname: Soran
authors.affiliation: From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK From the Faculty of Medical and Human Sciences, The University of Manchester, Manchester, Department of Diabetes, Endocrinology and Obesity Medicine, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford, Department of Bariatric and Upper Gastrointestinal Surgery, Salford Royal NHS Foundation Trust and University Teaching Hospital, Salford and Cardiovascular Trials Unit, Central Manchester University Hospital NHS Foundation Trust, Manchester, UK aas@DrSyed.org.
authors.forename: A A
authors.initials: AA
authors.lastname: Syed
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D001794:Blood Pressure; D015992:Body Mass Index; D008076:Cholesterol, HDL / Q000097:blood*; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications / Q000601:surgery; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D008076:Cholesterol, HDL