Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus
Abstract
Objective: To evaluate pre‐ and postoperative clinical parameters associated with improvement of diabetes up to 4 years after laparoscopic Roux‐en‐Y gastric bypass (LRYGBP) in patients with type 2 diabetes mellitus (T2DM). Summary background data: The surgical treatment of morbid obesity leads to dramatic improvement in the comorbidity status of most patients with T2DM. However, little is known concerning what preoperative clinical factors are associated with postoperative long‐term improvement in diabetes in the morbidly obese patient with diabetes. Methods: We evaluated pre‐ and postoperative data, including demographics, duration of diabetes, metabolic parameters, and clinical outcomes, in all patients with impaired fasting glucose (IFG) and type T2DM undergoing LRYGBP from July 1997 to May 2002. Results: During this 5‐year period, 1160 patients underwent LRYGBP, and 240 (21%) had IFG or T2DM. Follow‐up was possible in 191 of 240 patients (80%). There were 144 women (75%) with a mean preoperative age of 48 years (range, 26–67 years). After surgery, weight and body mass index decreased from 308 lbs and 50.1 kg/m2 to 211 lbs and 34 kg/m2 for a mean weight loss of 97 lbs and mean excess weight loss of 60%. Fasting plasma glucose and glycosylated hemoglobin concentrations returned to normal levels (83%) or markedly improved (17%) in all patients. A significant reduction in use of oral antidiabetic agents (80%) and insulin (79%) followed surgical treatment. Patients with the shortest duration (<5 years), the mildest form of T2DM (diet controlled), and the greatest weight loss after surgery were most likely to achieve complete resolution of T2DM. Conclusion: LRYGBP resulted in significant weight loss (60% percent of excess body weight loss) and resolution (83%) of T2DM. Patients with the shortest duration and mildest form of T2DM had a higher rate of T2DM resolution after surgery, suggesting that early surgical intervention is warranted to increase the likelihood of rendering patients euglycemic.
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Partial or total remission rates in type 2 diabetes as high as 80% to 90% occur following bariatric surgery.
“Partial or total remission rates in type 2 diabetes as high as 80% to 90% have been observed to occur following bariatric surgery [40-45].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [42]
Patients with shorter duration of diabetes and/or less severity (not requiring insulin) are more likely to undergo complete remission following bariatric surgery.
“Patients with shorter duration of diabetes and/or less severity (not requiring insulin) are more likely to undergo complete remission following bariatric surgery [42].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [42]
Postoperative complete remission of type 2 diabetes is mostly dependent on the duration and severity of the diabetes.
“It is known that postoperative complete remission of type 2 diabetes is mostly dependent on the duration and severity of the diabetes.”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [42]
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- Authors
- Schauer, P., Burguera, B., Ikramuddin, S., Cottam, D., Gourash, W., Hamad, G., Eid, G., Mattar, S., Ramanathan, R., Barinas‐Mitchel, E., Rao, R., Kuller, L., & Kelley, D.
- Affiliations
- University of Minnesota (US)
- Venue
- Nutrition in Clinical Practice
- Publisher
- Wiley
- Published
- 2004-02
- Volume
- 19
- Issue
- 1
- Pages
- 60-61
- ISSN
- 0884-5336 (ISSN-L)
- 1941-2452
- OpenAlex
- W1973386775
- Cited by
- 95
- References
- 0
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 7 · 2022: 8 · 2021: 8 · 2020: 8 · 2019: 8 · 2018: 6 · 2017: 5 · 2016: 6 · 2015: 1 · 2014: 7 · 2013: 4 · 2012: 5
- FWCI
- 0.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition in Clinical Practice (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- laparoscopic Roux-en-Y gastric bypass, type 2 diabetes, morbid obesity, diabetes resolution, impaired fasting glucose, weight loss, excess weight loss, diabetes duration, oral antidiabetic drugs, insulin use, HbA1c, bariatric surgery
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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