Researchers evaluated 652 patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGBP) at a single facility between March 2003 and December 2009. Follow-up was performed for a mean of 2.88 years after surgery. The cohort included 170 patients who had preoperative type 2 diabetes mellitus (T2DM).
Across all participants, the mean maximum excess weight loss (EWL) was 77.1%, with two-thirds of participants regaining an average of 19.1% of maximum EWL during follow-up. Most patients with T2DM (82.7%) were in remission upon completion of follow-up, with 5.8% of those with diabetes experiencing recurrence after remission. Recurrence was significantly associated with insulin use (75% compared with 18%) and longer T2DM duration (12.3 years vs. 6 years) compared with those who did not experience recurrence. Investigators said neither the maximum EWL nor the amount of weight regained were significantly different between recurrent and nonrecurrent patients.
"Weight regain after LRYGBP is common, but not associated with remission," the researchers concluded. "Recurrence of T2DM after remission … is associated with longer duration of T2DM and insulin use. Early surgical intervention for morbidly obese patients with T2DM should be recommended to maximize remission rates."
Presented at the Society of American Gastrointestinal and Endoscopic Surgeons Annual Meeting in Baltimore. April 17, 2013, Taitano AA. P005: Weight Regain Does Not Impact Remission of Diabetes After Gastric Bypass.