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Degree

MS, University of Cincinnati, Allied Health Sciences: Nutrition, 2012.

Abstract

Bariatric surgery produces Type 2 diabetes (T2DM) improvement or remission in a subset of obese patients and has recently been endorsed as an effective therapy for the treatment of T2DM by the International Diabetes Federation taskforce. Several factors, such as age, glycemic control, medication regimen, and years with T2DM have been associated with T2DM remission, but it is still unknown if these factors are equally relevant for Roux-en-Y gastric bypass (RYGB) and adjustable gastric banding (AGB) patients. The purpose of this study was to examine the predictive value of the factors associated with remission following these surgeries using a retrospective chart review of 92 RYGB and 74 adjustable gastric banding patients. When both surgery groups were examined together, there were significant differences between the remission group and the no remission group in age, % excess weight lost (%EWL), and years with diabetes. When split into subgroups by surgery type and remission status, the AGB remission group was significantly younger than the group that did not experience remission. The RYGB remission subgroups showed significant differences in %EWL and years with diabetes, but not age. Baseline glucose levels, diet-controlled diabetes, and %EWL were significant predictors of remission at 1 year when all subjects were examined together. None of these factors predicted remission in the AGB subgroup at 1 year or the final time point while insulin use predicted failure to achieve remission in the RYGB group at both time points. At the final time point (mean = 19 months, range 12 – 36 months), %EWL and control of diabetes with diet alone predicted remission in the group as a whole. When analysis was limited to subjects under the age of 50, there was no significant difference between the T2DM remission rates in the AGB and RYGB groups. In conclusion, the predictors of T2DM remission following bariatric surgery differ depending on the type of surgery being considered. With more research, these factors may be used to identify which surgery is most suitable for each patient.

Subject Headings

Surgery

Keywords

Diabetes; bariatric surgery; Roux-en-Y; Adjustable gastric banding

Committee / Advisors

Seung-Yeon Lee, PhD (Committee Chair)
Debra Ann Krummel, PhD (Committee Member)

Pages

45p.

Document number: ucin1342103432
Permalink: http://rave.ohiolink.edu/etdc/view?acc_num=ucin1342103432

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