Background

The aim of this study was to investigate the effect of bariatric surgery on the remission rate of type 2 diabetes mellitus (T2DM) and factors affecting it in patients with obesity and T2DM for more than 1 year after bariatric surgery.

Results

Of the 170 patients who underwent bariatric surgery in the period, 83 patients with T2DM were included in this study. Mean age was 48.2+-11.1year, male sex ratio was 26.5% and mean BMI was 36.6+-6.3kg/m². Three types of laparosopic bariatric surgeries were performed; 24 sleeve gastrectomies (28.9%), 55 Roux-en-Y gastric bypasses (66.3%), and 4 sleeve gastrectomy with duodenojejunal bypasses (4.8%). Percentage total body weight loss was 22.3+-6.6% at 1 year after surgery. The remission rates of T2DM (HbA1C<6.5% and not taking any T2DM medication) were achieved 71.4% at 6 months and 81.0%, at 1 year after surgery. Significant improvements at 1 year after surgery were observed in HbA1c (-1.6+-1.2mg/dL), triglycerides (-75.0+-82.9mg/dL), HDL-Cholesterol (+7.2+-10.7mg/dL), systolic blood pressure (-19.9+-21.0mmHg), diastolic blood pressure (-13.3+-15.2mmHg) and insulin resistance (HOMA-IR, -6.1+-8.3). Univariate analysis identified lower ABCD score, higher HbA1c, lower preoperative insulinogenic index(IGI), usage of oral anti-diabetic medication, and usage of insulin treatment were significant risk factors. Multivariate analysis confirmed that higher IGI and shorter duration of T2DM were independent favoring factors of the remission of T2DM.

Conclusions

Bariatric surgery can be considered as an effective treatment option for remission of T2DM, and patients with higher preoperative IGI showed better outcomes at 1 year after bariatric surgery.