title: Predictors of short-term diabetes remission after laparoscopic Roux-en-Y gastric bypass.
abstract: OBJECTIVE
  A remission of type 2 diabetes mellitus (T2DM) is one of the major goals of the contemporary bariatric surgery. The goal of our study is to identify predictors of short-term postoperative diabetes remission in order to facilitate preoperative patient selection.
  
  
  METHODS
  Two hundred forty-five obese (body mass index (BMI) ≥35 kg/m2) T2DM subjects who underwent laparoscopic Roux-en-Y gastric bypass (RYGB) were followed up to 1 year after bariatric surgery. Diabetes remission was defined as hemoglobin A1c (HbA1c) ≤6 % and fasting blood glucose (FBG) <100 mg/dl in absence of all diabetic medications.
  
  
  RESULTS
  Twenty-six percent of the patients seen in f/u achieved complete remission at 1 year. Average Hba1c decreased from 8 to 6.7% and 6.4% after 6 and 12 months, respectively. Regression analysis showed that age (p = 0.01), number of diabetes complications (p = 0.03), family history of diabetes (p = 0.04), preoperative use of insulin (p = 0.04), and peri- and postoperative weight loss (p = 0.05, for both) were the best preoperative predictors of diabetes remission at 6 and 12 months (R(2) = 0.3).
  
  
  CONCLUSIONS
  Younger patients, with fewer diabetic complications, no family history of diabetes, not using insulin, and with greater peri- and postoperative weight loss were the best candidates to achieve a rapid diabetes remission after RYGB.
authors.affiliation: Division of Diabetes, Endocrinology and Metabolism, University of Miami, 1400 NW 10th Ave, Dominion Tower suite 805-807, Miami, FL, 33136, USA, giacobellis@med.miami.edu.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Iacobellis
authors.forename: Chengyu
authors.initials: C
authors.lastname: Xu
authors.forename: Rafael E
authors.initials: RE
authors.lastname: Campo
authors.forename: Nestor F
authors.initials: NF
authors.lastname: De La Cruz-Munoz
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D018579:Patient Selection; D011446:Prospective Studies; D012074:Remission Induction; D016896:Treatment Outcome