title: Prediction of Diabetes Remission in Morbidly Obese Patients After Roux-en-Y Gastric Bypass.
abstract: BACKGROUND
  Morbidly obese patients with type 2 diabetes have shown significant improvement in glycemic control after Roux-en-Y gastric bypass (RYGB). This study aimed to elucidate the predictors of diabetes remission.
  
  
  METHODS
  A retrospective review of a prospectively established database identified 134 type 2 diabetes patients who underwent laparoscopic RYGB between January 2011 and February 2014. Partial and complete remission of diabetes was defined as glycated hemoglobin (HbA1c) level <6.5 and <6.0%, respectively, without the use of antidiabetic medication. Pre- and postoperative clinical outcomes were compared between the remission and non-remission groups to identify the predictors of partial or complete remission of diabetes.
  
  
  RESULTS
  The mean duration of diabetes and preoperative HbA1c level were 4.6 years and 8.0%, respectively. The body mass index (BMI) of the enrolled patients decreased from 37.9 to 28.8 kg/m(2) during the mean follow-up of 12.3 months; 61.8% of the patients achieved partial or complete remission of diabetes. Multivariate analysis revealed that age at operation (odds ratio [OR] = 0.880; 95% confidence interval [CI] 0.807-0.960), HbA1c level (OR = 0.527; 95% CI 0.325-0.854), and C-peptide level (OR = 1.463; 95% CI 1.054-2.029) in the preoperative laboratory study, and the percentage of total weight loss (%TWL) (OR = 1.186; 95% CI 1.072-1.313) after RYGB were the independent predictors of partial or complete diabetes remission.
  
  
  CONCLUSIONS
  The predictive factors for diabetes remission after RYGB include age at operation, HbA1c and C-peptide levels, and the %TWL after surgery.
authors.affiliation: Department of Surgery, Seoul Hospital, Soonchunhyang University, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Republic of Korea.|Department of Surgery, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Surgery, Seoul Hospital, Soonchunhyang University, 59, Daesagwan-ro, Yongsan-gu, Seoul, 140-743, Republic of Korea. yjgs1997@gmail.com.
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D012074:Remission Induction; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Diabetes remission; Morbid obesity; Roux-en-Y gastric bypass; Type 2 diabetes