Predicting remission of diabetes after RYGB surgery following intensive management to optimize preoperative glucose control

Obes Surg. 2015 Jan;25(1):1-6. doi: 10.1007/s11695-014-1339-2.


Background: The purpose of the study is to investigate the association of preoperative glucose optimization prior to a Roux-en-Y gastric bypass (RYGB) and diabetes remission.

Methods: The study is a retrospective review of 245 patients with a history of diabetes type II and a RYGB from 2008 to 2012 at UMass Memorial Hospital.

Results: Patients that benefited from glucose optimization prior to RYGB were more likely to achieve diabetes remission 1 year after surgery. The preoperative glucose optimization intervention demonstrated that when patients decreased their HbA1c prior to surgery by 1 %, these individuals were 68 % more likely to remit (p = 0.015). Duration of diabetes (p = 0.005) and insulin use (p < 0.001) were also significant predictors of remission, whereas age, race, and gender were not.

Conclusions: Our study results indicate that a greater degree of glycemic improvement in response to presurgical medical intervention is associated with higher rates of diabetes remission post-operatively among obese adults with diabetes type II. Conversely, the lack of favorable glycemic response to intensification of medical management predicts a poor glycemic response to bariatric surgery. Further research is needed to determine if this difference is due to physiological factors or is simply an indicator of patient behavior.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Bariatric Surgery / methods
  • Blood Glucose / drug effects
  • Blood Glucose / metabolism*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / surgery*
  • Female
  • Follow-Up Studies
  • Gastric Bypass* / methods
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / blood
  • Obesity, Morbid / complications
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / surgery*
  • Preoperative Care / methods*
  • Prognosis
  • Remission Induction
  • Retrospective Studies
  • Weight Loss / physiology


  • Blood Glucose