title: "Dual-remission" after Roux-en-Y gastric bypass surgery: Glycemic variability cannot always be improved in Chinese obese patients with type 2 diabetes.
abstract: BACKGROUND
  Glycemic variability after Roux-en-Y Gastric Bypass (RYGB) has not been adequately examined in Chinese obese patients with type 2 diabetes (T2D).
  
  
  OBJECTIVE
  We aimed to evaluate glucose variability after RYGB by continuous glucose monitoring (CGM) and then evaluate the remission rate based on the complete diabetes remission criteria combined with normal ranges of CGM for the Chinese population, which we defined as "dual-remission."
  
  
  METHODS
  The study was done at our academic university-affiliated hospital.
  
  
  METHODS
  Over a 3-day period, CGM was performed on 43 Chinese obese T2D patients combined with a mixed-meal test before and 1 year after RYGB. Mean amplitude of glucose excursions (MAGE), standard deviations (SD), and the time that patients' blood glucose levels were≥7.0 mmol/L,≥7.8 mmol/L,≥11.1 mmol/L, and≤3.9 mmol/L within 24 hours was analyzed. Multiple logistic regression analyses were used to identify predictors of "dual-remission."
  
  
  RESULTS
  Complete diabetes remission was achieved in 27 patients (62.8%) 1 year after RYGB. However, MAGE didn't change in the group, and only 18.6% patients met "dual-remission." Compared with patients in the complete remission group, patients in the dual-remission group had a shorter duration of diabetes, younger age, lower glycated hemoglobin (HbA1c) level, and no insulin usage at baseline. Correlation analysis showed MAGE after RYGB was positively correlated with diabetes duration (r = .43, P<.01). Multiple logistic regressions indicated a shorter duration was associated with a higher possibility to achieve dual-remission after adjusting for age, gender, HbA1c, and insulin therapy.
  
  
  CONCLUSIONS
  Glucose variability can't be effectively improved in most Chinese obese diabetic patients after RYGB. Shorter diabetes duration was associated with higher possibility to achieve "dual-remission."
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
authors.forename: Haoyong
authors.initials: H
authors.lastname: Yu
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China; Department of Endocrinology and Metabolism, Kashgar Prefecture Second People's Hospital, Kashgar, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
authors.forename: Yuqian
authors.initials: Y
authors.lastname: Bao
authors.affiliation: Department of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
authors.lastname: Pin Zhang
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.affiliation: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center of Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Key Clinical Center for Metabolic Disease, Shanghai, China. Electronic address: wpjia@sjtu.edu.cn.
authors.forename: Weiping
authors.initials: W
authors.lastname: Jia
mesh_terms: D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D002681:China / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000208:ethnology / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D061385:Insulins / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000208:ethnology / Q000601:surgery*; D012074:Remission Induction; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000502:physiology
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D061385:Insulins
keywords: Bariatric surgery; Continuous glucose monitoring; Diabetes; Gastric bypass; Glycemic variability; Obesity