title: Gastric bypass significantly improves quality of life in morbidly obese patients with type 2 diabetes.
abstract: To evaluate the impact of Roux-en-Y gastric bypass (RYGB) on quality of life in obese diabetic patients compared to standard medical therapy for type 2 diabetes mellitus.
  
  
  
  We prospectively studied two matched obese populations with type 2 diabetes. Thirty patients underwent laparoscopic RYGB and 31 received standard medical therapy combined with a diabetes support and education program (DSE), consisting of educational sessions on diet and exercise. Groups were matched by age, gender, weight, glucostatic parameters, and use of glucose-lowering medications (oral agents and insulin therapy). Health-related quality of life (HRQOL) was assessed using the normalized SF-36 questionnaire, and data were collected at baseline and at 12-month follow-up.
  
  
  
  Diabetic patients who underwent RYGB experienced a statistically significant increase in their overall HRQOL. However, the role-physical and mental health domains increased but did not reach statistical significance. Diabetic patients in the medical therapy and DSE group did not show any significant increase in HRQOL. The between-group differences for the HRQOL changes from baseline were significant, other than for role-physical and mental health domains. Percentage changes in glucostatic parameters, discontinuation of glucose-lowering medications, and T2DM remission were not found to predict the percentage change in SF-36 scores at 12 months after RYGB.
  
  
  
  For the first time, with a prospective matched control study, we demonstrate a significant improvement in HRQOL in obese diabetic patients who underwent RYGB, but not in those who were offered standard medical therapy and DSE.
authors.affiliation: Section of Metabolic and Bariatric Surgery, Rush University Medical Center, Rush University, Chicago, IL, USA.
authors.forename: Philip
authors.initials: P
authors.lastname: Omotosho
authors.affiliation: Department of Surgery, Duke University, Durham, NC, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Mor
authors.affiliation: Division of Nutrition and Biochemical Medicine, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Prapimporn Chattranukulchai
authors.initials: PC
authors.lastname: Shantavasinkul
authors.affiliation: Division of Endocrinology, Metabolism, and Nutrition, Duke University, Durham, NC, USA.
authors.forename: Leonor
authors.initials: L
authors.lastname: Corsino
authors.affiliation: Section of Metabolic and Bariatric Surgery, Rush University Medical Center, Rush University, Chicago, IL, USA. alfonso_torquati@rush.edu.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Torquati
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D016022:Case-Control Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D015444:Exercise; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000627:therapeutic use; D010535:Laparoscopy; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000378:metabolism / Q000601:surgery*; D011446:Prospective Studies; D011788:Quality of Life; D015431:Weight Loss
chemical_list: D007004:Hypoglycemic Agents; D007328:Insulin
keywords: Bariatric surgery; Diabetes; Gastric bypass; Quality of life
references.citation: Diabetes Care. 2013 Jan;36 Suppl 1:S11-66
references.pmid: 23264422
references.citation: Qual Life Res. 2001;10(5):405-13; discussion 415-20
references.pmid: 11763203
references.citation: Health Qual Life Outcomes. 2009 Jun 09;7:53
references.pmid: 19505338
references.citation: Endocr Rev. 1985 Winter;6(1):45-86
references.pmid: 3884329
references.citation: Obes Res. 2001 Nov;9(11):713-21
references.pmid: 11707538
references.citation: Cochrane Database Syst Rev. 2009 Apr 15;(2):CD003641
references.pmid: 19370590
references.citation: Br J Surg. 2010 Oct;97(10):1541-6
references.pmid: 20645295
references.citation: Diabetes Metab Res Rev. 1999 May-Jun;15(3):205-18
references.pmid: 10441043
references.citation: JAMA. 2003 Jan 1;289(1):76-9
references.pmid: 12503980
references.citation: Surg Obes Relat Dis. 2012 May-Jun;8(3):346-54
references.pmid: 22336495
references.citation: Ann Surg. 2014 Mar;259(3):494-501
references.pmid: 23732262
references.citation: Diabetes Care. 2005 Feb;28(2):443-4
references.pmid: 15677813
references.citation: Surg Obes Relat Dis. 2010 Nov-Dec;6(6):608-14
references.pmid: 20947446
references.citation: Nutr Hosp. 2013 Mar;28 Suppl 2:66-77
references.pmid: 23834049
references.citation: Diabetes Care. 1998 Jun;21(6):930-5
references.pmid: 9614610
references.citation: Diabetes Metab. 2013 Apr;39(2):148-54
references.pmid: 23313223
references.citation: Qual Life Res. 2004 Feb;13(1):73-80
references.pmid: 15058789
references.citation: Health Qual Life Outcomes. 2013 Oct 16;11:170
references.pmid: 24131673
references.citation: Int J Obes Relat Metab Disord. 1998 Feb;22(2):113-26
references.pmid: 9504319
references.citation: JAMA. 2004 Oct 13;292(14):1724-37
references.pmid: 15479938
references.citation: Am J Surg. 2007 Apr;193(4):471-5
references.pmid: 17368291
references.citation: N Engl J Med. 2012 Apr 26;366(17):1577-85
references.pmid: 22449317
references.citation: Int J Obes (Lond). 2008 Sep;32(9):1431-7
references.pmid: 18607383
references.citation: Diabetes Care. 2004 Aug;27(8):2067-73
references.pmid: 15277443
references.citation: Diabetes Care. 1994 Apr;17(4):267-74
references.pmid: 8026281
references.citation: Am J Clin Nutr. 1992 Feb;55(2 Suppl):611S-614S
references.pmid: 1733139
references.citation: Value Health. 2013 Sep-Oct;16(6):993-1000
references.pmid: 24041349
references.citation: Obes Surg. 2010 Mar;20(3):302-7
references.pmid: 19949889
references.citation: Diabetes Care. 1998 Feb;21(2):236-40
references.pmid: 9539988
references.citation: Soc Sci Med. 1998 Jun;46(12):1569-85
references.pmid: 9672396
references.citation: Am J Med. 2009 Mar;122(3):248-256.e5
references.pmid: 19272486
references.citation: Diabetes Care. 1997 Apr;20(4):562-7
references.pmid: 9096981
references.citation: J Clin Epidemiol. 2001 Sep;54(9):928-34
references.pmid: 11520653
references.citation: Diabetologia. 1985 Jul;28(7):412-9
references.pmid: 3899825
references.citation: N Engl J Med. 2012 Apr 26;366(17):1567-76
references.pmid: 22449319