Effect of Roux-en-Y Gastric Bypass on Remission of T2D: Medium-Term Follow-up in Chinese Patients with Different BMI Obesity Class

Hongwei Zhang, Xiaodong Han, Haoyong Yu, Jianzhong Di, Pin Zhang, Weiping Jia

Roux-en-Y gastric bypass (RYGB) is an effective treatment for patients with type 2 diabetes mellitus (T2D) with obesity. However, T2D remission after surgery has not been adequately studied in Chinese patients with different obesity classes. The purpose of this study is to evaluate the medium-term metabolic results of RYGB in T2D patients with body mass index (BMI) >25 kg/m(2) compared by obesity class. We retrospectively divided 120 Chinese patients with T2D and BMI >25 kg/m(2) into four groups from overweight to obesity class III and reviewed their medical records for metabolic outcomes 36 months after RYGB. T2D remission was defined as glycated hemoglobin <6.0 % and no current medications. Hypertension, dyslipidemia, cardiovascular risk, and medications were also evaluated. Sixty-two patients (62/120, 51.6 %) were female. All surgeries were performed laparoscopically without mortality or major complications. Mean follow-up duration was 38.7 ± 9.1 months and follow-up compliance was 86.7 %. Patients with BMI ≥28 kg/m(2) benefitted more from weight loss following RYGB. Medication and remission results for hypertension and dyslipidemia did not differ significantly between groups. There was a significant reduction in the need for oral medication or insulin in all four groups. T2D remission occurred in 44-66.7 % of all patients at 36 months with no significant difference between groups. Initial BMI was correlated with A1C 36 months after surgery (r = -0.217, P = 0.027). RYGB effectively treated T2D patients in our study, even in low-BMI patients, and resulted in diabetes remission and metabolic disorder control, reducing cardiovascular risk.