Long-term outcomes of diabetes after laparoscopic Roux-en-Y gastric bypass in a Lebanese bariatric practice

Abstract

Introduction: Roux-Y-gastric bypass (RYGB) is highly effective in treating obesity related type II diabetes mellitus (DM). There are a few studies from the Middle East and North Africa (MENA) on the impact of RYGB on DM. Objective: The aim of our study was to evaluate the impact of RYGB on DM in our patient population. Methods: We retrospectively reviewed our database and selected obese patients with type II DM who underwent primary laparoscopic RYGB from 2005 to 2015. Complete remission (CR) of DM was defined as HbA1c < 5.7%, FBG < 100 mg/dL without medications. Partial remission (PR) was defined as HbA1c 5.7–6.4%, FBG 100–125 mg/dL without medications. Improvement was defined by a significant reduction in HbA1c (> 1%) or FBG (> 25 mg/dL) or reduction in HbA1c and FBG accompanied by discontinuing insulin. Results: Out of 245 RYGB patients, 107 had DM. In comparison, diabetic patients were older and had more hypertension and dyslipidemia. At 5 years with a follow-up (F/U) of 56%, total weight loss in diabetics (24.7%) was lower than non-diabetics (27.7%). At a mean F/U of 5.6 ± 2.7 years, range (1.4 to 10.7), there was a significant reduction in HbA1C (7.9 to 6.1%), FBG (158 to 111 mg/dL), intake of oral hypoglycemic (73.6 to 29.7%), as well as insulin therapy (15.4 to 2.2%). The rate of DM CR was 42.3%, PR 20.5%, improvement 23.1%, and no change 14.1%. Conclusion: This is the first report from the MENA region on the long-term outcomes of RYGB in the treatment of type II DM. The results are similar to those in the international literature. © 2019, Research Society for Study of Diabetes in India.