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Efficacy of Bariatric Surgery in Type 2 Diabetes Mellitus Remission: the Role of Mini Gastric Bypass/One Anastomosis Gastric Bypass and Sleeve Gastrectomy at 1 Year of Follow-up. A European survey

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Abstract

Background

A retrospective study was undertaken to define the efficacy of both mini gastric bypass or one anastomosis gastric bypass (MGB/OAGB) and sleeve gastrectomy (SG) in type 2 diabetes mellitus (T2DM) remission in morbidly obese patients (pts).

Methods

Eight European centers were involved in this survey. T2DM was preoperatively diagnosed in 313/3252 pts (9.62 %). In 175/313 patients, 55.9 % underwent MGB/OAGB, while in 138/313 patients, 44.1 % received SG between January 2006 and December 2014.

Results

Two hundred six out of 313 (63.7 %) pts reached 1 year of follow-up. The mean body mass index (BMI) for MGB/OAGB pts was 33.1 ± 6.6, and the mean BMI for SG pts was 35.9 ± 5.9 (p < 0.001). Eighty-two out of 96 (85.4 %) MGB/OAGB pts vs. 67/110 (60.9 %) SG pts are in remission (p < 0.001). No correlation was found in the % change vs. baseline values for hemoglobin A1c (HbA1c) and fasting plasma glucose (FPG) in relation to BMI reduction, for both MGB/OAGB or SG (ΔFPG 0.7 and ΔHbA1c 0.4 for MGB/OAGB; ΔFPG 0.7 and ΔHbA1c 0.1 for SG). At multivariate analysis, high baseline HbA1c [odds ratio (OR) = 0.623, 95 % confidence interval (CI) 0.419–0.925, p = 0.01], preoperative consumption of insulin or oral antidiabetic agents (OR = 0.256, 95 % CI 0.137–0.478, p = <0.001), and T2DM duration >10 years (OR = 0.752, 95 % CI 0.512–0.976, p = 0.01) were negative predictors whereas MGB/OAGB resulted as a positive predictor (OR = 3.888, 95 % CI 1.654–9.143, p = 0.002) of diabetes remission.

Conclusions

A significant BMI decrease and T2DM remission unrelated from weight loss were recorded for both procedures if compared to baseline values. At univariate and multivariate analyses, MGB/OAGB seems to outperform significantly SG. Four independent variables able to influence T2DM remission at 12 months have been identified.

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Acknowledgments

The authors would like to acknowledge Prof. Maurizio Taglialatela and Ms. Sandra Zavaleta for their precious help in drafting this manuscript.

Conflict of Interest

Authors Mario Musella, Jan Apers, Karl Rheinwalt, Rui Ribeiro, Emilio Manno, Francesco Greco, Michal Čierny, Marco Milone, Carla Di Stefano, Sahin Guler, Isa Mareike Van Lessen, Anabela Guerra, Mauro Natale Maglio, Riccardo Bonfanti, Radoslava Novotna, Guido Coretti, and Luigi Piazza (1), in the past 5 years, have not received reimbursements, fees, funding, or salary from an organization that may in any way gain or lose financially from the publication of this manuscript, either now or in the future; (2) do not hold any stocks or shares in an organization that may in any way gain or lose financially from the publication of this manuscript, either now or in the future; (3) do not hold or are not currently applying for any patents relating to the content of the manuscript; (4) have not received reimbursements, fees, funding, or salary from an organization that holds or has applied for patents relating to the content of the manuscript; (5) do not have any other financial competing interests or financial ties to disclose; and (6) do not have non-financial competing interests (political, personal, religious, ideological, academic, intellectual, commercial, or any other) to declare in relation to this manuscript.

Ethical Approval

This is a retrospective study. For this type of study, ethical formal consent is not required.

Informed Consent

No identifying information of any patient included in the study is available in the article.

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Authors and Affiliations

  1. Department of Advanced Biomedical Sciences, “Federico II” University, Via S. Pansini 5, Building 12, 80131, Naples, Italy

    Mario Musella, Marco Milone & Guido Coretti

  2. Leeuwarden Medical Center, Leeuwarden, The Netherlands

    Jan Apers & Sahin Guler

  3. St. Franziskus Hospital, Cologne, Germany

    Karl Rheinwalt & Isa Mareike Van Lessen

  4. Centro Hospitalar de Lisboa Central, Lisbon, Portugal

    Rui Ribeiro & Anabela Guerra

  5. AORN “A. Cardarelli”, Naples, Italy

    Emilio Manno & Mauro Natale Maglio

  6. Clinica “Castelli”, Bergamo, Italy

    Francesco Greco & Riccardo Bonfanti

  7. Břeclav Hospital, Břeclav, Czech Republic

    Michal Čierny & Radoslava Novotna

  8. AORN “G. Garibaldi”, Catania, Italy

    Carla Di Stefano & Luigi Piazza

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Correspondence to Mario Musella.

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Musella, M., Apers, J., Rheinwalt, K. et al. Efficacy of Bariatric Surgery in Type 2 Diabetes Mellitus Remission: the Role of Mini Gastric Bypass/One Anastomosis Gastric Bypass and Sleeve Gastrectomy at 1 Year of Follow-up. A European survey. OBES SURG 26, 933–940 (2016). https://doi.org/10.1007/s11695-015-1865-6

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  • DOI: https://doi.org/10.1007/s11695-015-1865-6

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