Equivalent weight loss with marked metabolic benefit observed in a matched cohort with and without type 2 diabetes 12 months following gastric bypass surgery

Obes Surg. 2012 Nov;22(11):1723-9. doi: 10.1007/s11695-012-0719-8.

Abstract

Background: Bariatric surgery results in dramatic weight loss and improves metabolic syndrome and type 2 diabetes (T2DM). However, previous studies have noted that morbidly obese patients with T2DM experience less weight loss benefits than non-diabetic patients following bariatric surgery. We sought to determine longitudinal effects of laparoscopic Roux-en-Y gastric bypass (LRYGB) on percent excess body mass index (BMI) loss (%EBMIL) and clinical metabolic syndrome parameters in patients with T2DM compared with appropriately matched cohort without T2DM.

Methods: Retrospective cohort analysis of T2DM patients (n = 126) to non-T2DM patients (n = 126) matched on age (M = 48.1 ± 9.5), sex (81 % female), race (81 % Caucasian), and pre-surgical BMI (M = 49.3 ± 9.5). Lipids, glucose, hemoglobin A1c, blood pressure, co-morbidities of obesity, medications for co-morbidities, and T2DM medications were collected at baseline, 6 months and 12 months post-surgery. %EBMIL was collected at 1, 3, 6, 9, and 12 months post-surgery. One-way analyses of variance with effect sizes estimates were conducted to compare the two groups.

Results: As expected, T2DM subjects had significantly greater pre-surgical HbA1c, blood glucose, blood pressure, and lipid parameters at baseline vs. non-T2DM (all p values of<0.05). At 1, 3, 6, 9, and 12 months after LRYRB, both groups had similar reduction in %EBMIL (p > 0.10). At 6 months, there was a significant reduction in HbA1c, blood glucose, and lipid in the T2DM cohort compared with pre-surgical levels (p < 0.0001). At 12 months, these values were not different to that of the non-T2DM subjects (p > 0.10).

Conclusions: When matched on appropriate factors associated with weight loss outcomes, severely obese patients with T2DM have similar post-LRYGB weight loss outcomes in the first 12 months following surgery compared with non-T2DM patients. Furthermore, T2DM surgical patients achieved significant improvement in metabolic syndrome components.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biomarkers / blood
  • Blood Glucose / metabolism*
  • Body Mass Index
  • Case-Control Studies
  • Female
  • Follow-Up Studies
  • Gastric Bypass*
  • Glycated Hemoglobin A / metabolism*
  • Humans
  • Laparoscopy*
  • Lipids / blood
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / physiopathology
  • Metabolic Syndrome / surgery
  • Middle Aged
  • Obesity, Morbid / blood*
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / surgery
  • Retrospective Studies
  • Treatment Outcome
  • Weight Loss

Substances

  • Biomarkers
  • Blood Glucose
  • Glycated Hemoglobin A
  • Lipids
  • hemoglobin A1c protein, human