title: Dynamics of type 2 diabetes mellitus laboratory remission after Roux-en-Y gastric bypass in patients with body mass index lower than 35 kg/m(2) and higher than 35 kg/m(2) in a 3-year observation period.
abstract: BACKGROUND
  Bariatric surgery as treatment of type 2 diabetes mellitus (T2DM) in morbidly obese patients is becoming common. Although a large number of studies demonstrating high efficacy of bariatric methods in diabetics with body mass index (BMI) < 35 kg/m(2) have been published, this promising solution is still not accepted enough even in the era of a diabetes offensive.
  
  
  OBJECTIVE
  To analyze the dynamics of T2DM remission in patients with BMI < 35 kg/m(2) and > 35 kg/m(2) after Roux-en-Y gastric bypass (RYGB).
  
  
  METHODS
  Data of 30 patients with BMI < 35 kg/m(2) and 82 with BMI > 35 kg/m(2) who underwent RYGB between 2007 and 2010 were collected from a prospectively designed database. The laboratory resolution of T2DM was determined by fasting plasma glucose (FPG ≤ 100 mg/dl) and glycosylated hemoglobin (HbA1c ≤ 6%).
  
  
  RESULTS
  The T2DM regression was observed in 80% of the patients with BMI < 35 kg/m(2) and 83% in a group with BMI > 35 kg/m(2) 1 year after RYGB and about 80% 2 and 3 years after the operation in both groups. Normalization of average HbA1c and FPG was observed in the BMI > 35 kg/m(2) group after 3 months, while in the BMI < 35 kg/m(2) group it was reached 6 months postoperatively. Changes in main markers of T2DM were parallel with the BMI decrease 3-12 months after RYGB, but early resolution in some patients was observed independently of weight loss.
  
  
  CONCLUSIONS
  The mid-term observation of patients after RYGB revealed the laboratory remission of T2DM. Ultimate evaluation of T2DM markers 3 years after surgery demonstrates high effectiveness of RYGB in managing T2DM in both groups.
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Łukasz
authors.initials: Ł
authors.lastname: Kaska
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Proczko
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Jarek
authors.initials: J
authors.lastname: Kobiela
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Tomasz Jerzy
authors.initials: TJ
authors.lastname: Stefaniak
authors.affiliation: Department of General, Endocrine and Transplant Surgery, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Śledzinski
keywords: Roux-en-Y gastric bypass; body mass index below 35 kg/m2; remission; surgical treatment; type 2 diabetes mellitus