New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The "Time-Within-Remission Range"
Por:
de Hollanda, A, Lecube, A, Rubio, MA, Sanchez, E, Vilarrasa, N, Oliva, JG, Fernandez-Soto, ML, Salas-Salvado, J, Ballesteros-Pomar, MD, Ciudin, A, Torres, F, Vidal, C, Morales, MJ, Valdes, S, Pellitero, S, Minambres, I, Masmiquel, L, Goday, A, Suarez, L, Flores, L, Bueno, M, Caixas, A, Breton, I, Camara, R, Olbeyra, R, Penso, R, de la Cruz, MJ, Simo-Servat, A, Pereyra-Garcia, FM, Lopez-Mezquita, ET, Gils, A, Fidilio, E, Bandres, O, Martinez, A, Abuin, J, Marques-Pamies, M, Tuneu, L, Arteaga, M, Castaner, O, Goni, F, Arrizabalaga, C, Botana, MA, Calanas, A, Rebollo, A
Publicada:
1 abr 2020
Resumen:
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/m(2)) 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.
Filiaciones:
de Hollanda, A:
Hosp Clin Barcelona, Barcelona 08036, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona 08036, Spain
Inst Salud Carlos III ISCIII, CIBER Obesidad & Nutr CIBEROBN, Madrid 28029, Spain
Lecube, A:
Univ Lleida, Inst Recerca Biomed Lleida IRBLleida, Hosp Univ Arnau Vilanova, Grp Recerca Obesitat, Lleida 25198, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Enfermedades Metabol Asociadas CIB, Madrid 28029, Spain
Rubio, MA:
Hosp Clin San Carlos IDISSC, Madrid 28040, Spain
Sanchez, E:
Univ Lleida, Inst Recerca Biomed Lleida IRBLleida, Hosp Univ Arnau Vilanova, Grp Recerca Obesitat, Lleida 25198, Spain
Vilarrasa, N:
Hosp Univ Bellvitge, Inst Invest Biomed Bellvitge IDIBELL, Barcelona 08907, Spain
Oliva, JG:
Hosp Univ Nuestra Senora Candelaria, Santa Cruz De Tenerife 38010, Spain
Fernandez-Soto, ML:
Hosp Clin San Carlos IDISSC, Madrid 28040, Spain
Salas-Salvado, J:
Univ Rovita & Virgili Reus, Inst Invest Sanitaria Pere Virgili IISPV, Hosp Univ St Joan Reus, Tarragona 43204, Spain
Ballesteros-Pomar, MD:
Hosp Univ San Cecilio, Granada 18016, Spain
Hosp Leon, Leon 24008, Spain
Complejo Hosp Univ Vigo, Vigo 36312, Spain
Ciudin, A:
Hosp Univ Vall dHebron, Barcelona 08035, Spain
Torres, F:
Hosp Clin Barcelona, Clin Pharmacol Deparment, Med Stat Core Facil, Barcelona 08036, Spain
Univ Autonoma Barcelona, Biostat Unit, Fac Med, Barcelona 08193, Spain
Vidal, C:
Hosp Royo Villanova, Zaragoza 50015, Spain
Morales, MJ:
Complejo Hosp Univ Vigo, Vigo 36312, Spain
Valdes, S:
Univ Malaga, Inst Invest Biomed Malaga IBIMA, Hosp Reg Univ Malaga, Malaga 29010, Spain
Pellitero, S:
Hosp Univ Germans Trias Pujol, Inst Invest Germans Trias & IGTP, Badalona 08916, Spain
Minambres, I:
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Barcelona 08041, Spain
Masmiquel, L:
Hosp Univ Son Llatzer, Inst Invest Sanitaria Ias Islas Baleares IdISBa, Palma de Mallorca 07198, Spain
Goday, A:
Univ Autonoma Barcelona, Inst Hosp Mar Invest Mediques IMIM, Parc Salut Mar, Barcelona 08003, Spain
Suarez, L:
Hosp Univ Cent Asturias, Oviedo 33011, Spain
Flores, L:
Hosp Clin Barcelona, Barcelona 08036, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona 08036, Spain
Inst Salud Carlos III ISCIII, CIBER Diabet & Enfermedades Metabol Asociadas CIB, Madrid 28029, Spain
Bueno, M:
Univ Lleida, Inst Recerca Biomed Lleida IRBLleida, Hosp Univ Arnau Vilanova, Grp Recerca Obesitat, Lleida 25198, Spain
Caixas, A:
Univ Autonoma Barcelona, Inst Invest & Innovacio Parc Tauli I3PT, Hosp Univ Parc Tauli, Sabadell 08208, Spain
Breton, I:
Hosp Gen Univ Gregorio Maranon, Inst Invest Sanitaria Gregorio Maranon IISGM, Madrid 28007, Spain
Camara, R:
Hosp Univ & Politecn La Fe, Valencia 46026, Spain
Olbeyra, R:
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Barcelona 08036, Spain
Penso, R:
Hosp Cent Defensa Gomez Ulla, Madrid 28047, Spain
de la Cruz, MJ:
Hosp Univ Fdn Jimenez Diaz, Madrid 28040, Spain
Simo-Servat, A:
Hosp Mutua Terrassa, Terrassa 08221, Spain
Pereyra-Garcia, FM:
Hosp Univ Nuestra Senora Candelaria, Santa Cruz De Tenerife 38010, Spain
Lopez-Mezquita, ET:
Hosp Univ San Cecilio, Granada 18016, Spain
Gils, A:
Univ Rovita & Virgili Reus, Inst Invest Sanitaria Pere Virgili IISPV, Hosp Univ St Joan Reus, Tarragona 43204, Spain
Fidilio, E:
Hosp Univ Vall dHebron, Barcelona 08035, Spain
Bandres, O:
Hosp Royo Villanova, Zaragoza 50015, Spain
Martinez, A:
Complejo Hosp Univ Vigo, Vigo 36312, Spain
Abuin, J:
Univ Malaga, Inst Invest Biomed Malaga IBIMA, Hosp Reg Univ Malaga, Malaga 29010, Spain
Marques-Pamies, M:
Hosp Univ Germans Trias Pujol, Inst Invest Germans Trias & IGTP, Badalona 08916, Spain
Tuneu, L:
Hosp Univ Germans Trias Pujol, Inst Invest Germans Trias & IGTP, Badalona 08916, Spain
Univ Autonoma Barcelona, Hosp Santa Creu & Sant Pau, Barcelona 08041, Spain
Arteaga, M:
Hosp Univ Son Llatzer, Inst Invest Sanitaria Ias Islas Baleares IdISBa, Palma de Mallorca 07198, Spain
Castaner, O:
Univ Autonoma Barcelona, Inst Hosp Mar Invest Mediques IMIM, Parc Salut Mar, Barcelona 08003, Spain
Goni, F:
Hosp Basurto, Bilbao 48013, Spain
Arrizabalaga, C:
Hosp Basurto, Bilbao 48013, Spain
Botana, MA:
Hosp Univ Lucus Augusti, Lugo 27003, Spain
Calanas, A:
Hosp Univ Reina Sofia, Cordoba 14004, Spain
Rebollo, A:
Hosp Univ Reina Sofia, Cordoba 14004, Spain
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