TY - JOUR
T1 - Efficacy of Different Procedures of Metabolic Surgery for Type 2 Diabetes in Asia
T2 - a Multinational and Multicenter Exploratory Study
AU - Shen, Shih Chiang
AU - Lee, Wei Jei
AU - Kasama, Kazunori
AU - Seki, Yosuke
AU - Su, Yen Hao
AU - Wong, Simon Kin Hung
AU - Huang, Yu Min
AU - Wang, Weu
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021
Y1 - 2021
N2 - Introduction: Asian patients with diabetes exhibit different characteristics from Western patients. However, limited large-scale data are available on metabolic surgery procedures in Asia. We compared the short-term efficacies of metabolic surgery procedures for the management of Asian patients with different severities of diabetes. Methods: We included patients undergoing metabolic surgery in five Asian institutions from January 2008 to December 2015 with at least 1-year postoperative follow-up. Outcomes of weight loss and diabetes control were determined. Diabetes remission rates in different ABCD scores and factors affecting diabetes remission were analyzed. Results: A total of 1016 patients (mean BMI, 39.0 ± 7.2 kg/m2; HbA1c, 8.3% ± 1.7%) underwent metabolic surgery (197, Roux-en-Y gastric bypass [RYGB]; 171, one anastomosis gastric bypass [OAGB]; 437, sleeve gastrectomy [SG]; 130, SG with duodenal-jejunal bypass [SG-DJB]; and 81, single anastomosis duodenal-jejunal bypass with SG [SA-DJBSG]). The OAGB group exhibited significantly higher 1-year total weight loss (30.5%) and type 2 diabetes mellitus (T2DM) remission (78.4%) rates than did the other groups (p <.001). The patients with higher preoperative ABCD scores exhibited higher T2DM remission rates (81.8–100% and 9.5–46.2% in ABCD score subgroups of 9–10 and 1–2, respectively). In multivariate analysis, bypass was found to be an independent predictor of T2DM remission compared with SG (odds ratio of OAGB vs SG, 3.72; RYGB vs SG, 1.96; SG-DJB vs SG, 2.73; SA-DJBSG vs SG, 2.12). Conclusion: The metabolic surgeries are highly effective in T2DM treatment. However, SG may not be as effective as gastric bypass and duodenal-jejunum bypass.
AB - Introduction: Asian patients with diabetes exhibit different characteristics from Western patients. However, limited large-scale data are available on metabolic surgery procedures in Asia. We compared the short-term efficacies of metabolic surgery procedures for the management of Asian patients with different severities of diabetes. Methods: We included patients undergoing metabolic surgery in five Asian institutions from January 2008 to December 2015 with at least 1-year postoperative follow-up. Outcomes of weight loss and diabetes control were determined. Diabetes remission rates in different ABCD scores and factors affecting diabetes remission were analyzed. Results: A total of 1016 patients (mean BMI, 39.0 ± 7.2 kg/m2; HbA1c, 8.3% ± 1.7%) underwent metabolic surgery (197, Roux-en-Y gastric bypass [RYGB]; 171, one anastomosis gastric bypass [OAGB]; 437, sleeve gastrectomy [SG]; 130, SG with duodenal-jejunal bypass [SG-DJB]; and 81, single anastomosis duodenal-jejunal bypass with SG [SA-DJBSG]). The OAGB group exhibited significantly higher 1-year total weight loss (30.5%) and type 2 diabetes mellitus (T2DM) remission (78.4%) rates than did the other groups (p <.001). The patients with higher preoperative ABCD scores exhibited higher T2DM remission rates (81.8–100% and 9.5–46.2% in ABCD score subgroups of 9–10 and 1–2, respectively). In multivariate analysis, bypass was found to be an independent predictor of T2DM remission compared with SG (odds ratio of OAGB vs SG, 3.72; RYGB vs SG, 1.96; SG-DJB vs SG, 2.73; SA-DJBSG vs SG, 2.12). Conclusion: The metabolic surgeries are highly effective in T2DM treatment. However, SG may not be as effective as gastric bypass and duodenal-jejunum bypass.
KW - Metabolic surgery
KW - One anastomosis gastric bypass
KW - Predicting diabetes remission
KW - Roux-en-y gastric bypass
KW - Sleeve gastrectomy
KW - Sleeve gastrectomy with duodenal-jejunal bypass
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U2 - 10.1007/s11695-021-05239-7
DO - 10.1007/s11695-021-05239-7
M3 - Article
AN - SCOPUS:85100075318
SN - 0960-8923
VL - 31
SP - 2153
EP - 2160
JO - Obesity Surgery
JF - Obesity Surgery
IS - 5
ER -