Baseline Vitamin D as a Surrogate Marker for Type 2 Diabetes Remission and Weight Loss following Sleeve Gastrectomy

Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 786-P
Author(s):  
ALANOUD ALADEL ◽  
MILAN K. PIYA ◽  
SAHAR AZHARIAN ◽  
MARK CHRISTIAN ◽  
VINOD MENON ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Vitamin D ◽  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Surrogate Marker ◽  
Diabetes Remission ◽  
Type 2 Diabetes Remission

scholarly journals New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The “Time-Within-Remission Range”

2020 ◽  
Vol 9 (4) ◽  
pp. 1070
Author(s):  
Ana de Hollanda ◽  
Albert Lecube ◽  
Miguel Angel Rubio ◽  
Enric Sánchez ◽  
Núria Vilarrasa ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Diabetes Remission ◽  
Dynamic Responses ◽  
Type 2 Diabetes Remission

Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the “time-within-remission range” as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 ± 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, “time-within-remission range” and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 ± 9.2 years old, body mass index (BMI) 46.3 ± 6.9 kg/m2) underwent primary bariatric procedures. “Time-within-remission range” were 83.3% (33.3–91.6) after gastric bypass, 68.7% (7.1–87.5) after sleeve gastrectomy and 90% (83.3–92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the “time-within-remission range”. The association of bariatric techniques with “time-within-remission range”, using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34–5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40–0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The “time-within-remission range” unveils a superiority of gastric bypass compared to sleeve gastrectomy.

Association of Weight Loss With Type 2 Diabetes Remission Among Adults in Medically Underserved Areas: A Retrospective Cohort Study

2021 ◽  
pp. 089011712110244
Author(s):  
Ming Chen ◽  
Satya Surbhi ◽  
James E. Bailey
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Retrospective Cohort ◽  
Diabetes Remission ◽  
Medically Underserved ◽  
Remission Status ◽  
Medically Underserved Areas ◽  
Type 2 Diabetes Remission

Purpose: To examine the association between weight loss and type 2 diabetes remission among vulnerable populations living in medically underserved areas of the Mid-Southern United States. Design: Quantitative, retrospective cohort study. Setting: 114 ambulatory sites and 5 adults’ hospitals in the Mid-South participating in a regional diabetes registry. Participants: 9,900 adult patients with type 2 diabetes, stratified by remission status, with 1 year of baseline electronic medical record data, and 1 year of follow-up data for the 2015-2018 study period. Measures: The outcomes were diabetes remissions, categorized as any remission, partial remission, and complete remission based on the guidelines of the American Diabetes Association. The exposure was weight loss, calculated by the change in the Body Mass Index (BMI) as a proxy measure. Analysis: χ2 tests, Fisher’s exact tests, and the Mann-Whitney U-test were used to examine the differences in patient characteristics by remission status across the 3 remission categories, as appropriate. Multiple multivariable logistic regressions adjusting for confounders were performed to estimate the adjusted odds ratios (aORs) for the associations between weight loss and diabetes remission. Results: Among 9,900 patients identified, a reduction of 0.3 kg/m2 (standard deviation: 2.5) in the average BMI from the baseline to the follow-up was observed. 10.8% achieved any type of remission, with 9.8% for partial and 1.0% for complete remissions. Greater weight loss was significantly associated with an increased likelihood of any (aOR = 1.07, 95% confidence interval (CI), 1.06-1.08), partial (aOR 1.06, 95% CI, 1.04-1.07), and complete diabetes remission (aOR 1.10, 95% CI, 1.07-1.13). Conclusions: Weight loss is significantly associated with diabetes remission among patients living in medically underserved areas, but complete remission is rare.

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