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Title: New Metrics to Assess Type 2 Diabetes after Bariatric Surgery: The "Time-Within-Remission Range"
Author: Hollanda Ramírez, Ana M. de
Lecube, Albert
Rubio, Miguel Angel
Sánchez, Enric
Vilarrasa, Nuria
Oliva, José Gregorio
Fernández Soto, María Luisa
Salas Salvadó, Jordi
Ballesteros Pomar, María D.
Ciudin, Andrea
Torres, Ferran
Vidal, Concepción
Morales, María José
Valdés, Sergio
Pellitero, Silvia
Minambres, Inka
Masmiquel, Lluís
Goday, Albert
Suarez, Lorena
Flores, Liliam
Bueno, Marta
Caixàs i Pedragós, Assumpta
Bretón, Irene
Cámara, Rosa
Olbeyra, Romina
Penso, Rona
Cruz, María José de la
Simó Servat, Andreu
Pereyra García, Francisca María
López Mezquita, Elena Teresa
Gils, Anna
Fidilio, Enzamaria
Bandrés, Orosia
Martínez, Ángel
Abuín, Jose
Marques Pamies, Montserrat
Tuneu, Laura
Arteaga, Magdalena
Castañer, Olga
Goni, Fernando
Arrizabalaga, Cristina
Botana, Manuel Antonio
Calanas, Alfonso
Rebollo, Ángel
Keywords: Diabetis
Cirurgia de l'obesitat
Obesity surgery
Issue Date: 1-Apr-2020
Publisher: MDPI
Abstract: 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.
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It is part of: Journal of Clinical Medicine, 2020, vol. 9, num. 4
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Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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