New Criteria ID Fewer Cases of Post-Op Diabetes Remission

Significantly lower remission rate after gastric bypass with use of new definition of remission

FRIDAY, Jan. 6 (HealthDay News) -- Fewer patients with type 2 diabetes achieve diabetes remission following weight loss surgery, when employing the new, stricter criteria for diabetes remission issued by the American Diabetes Association (ADA), according to a study published in the January issue of the British Journal of Surgery.

Dimitrios J. Pournaras, M.R.C.S., of the Imperial College London, and colleagues retrospectively reviewed data from 1,006 patients who underwent gastric bypass, sleeve gastrectomy, and gastric banding surgery at three bariatric centers. They followed 209 of these patients who had type 2 diabetes for a median period of 23 months. The proportion of patients achieving complete remission of type 2 diabetes following bariatric surgery was assessed according to the new ADA definition (a return to normal measures of glucose metabolism -- HbA1c of <6 percent, fasting glucose of <5.6 mmol/L -- at least one year after surgery, without hypoglycemic medication) or the previously used definition (being off diabetes medication with normal fasting blood glucose level or HbA1c below 6 percent).

According to the new definition, the researchers found that 34.4 percent of patients had complete remission of diabetes. The remission rates varied significantly by procedure, with 40.6 percent of patients achieving remission after gastric bypass, 26 percent after sleeve gastrectomy, and 7 percent after gastric banding. Using the new definition, the remission rate for gastric bypass was significantly lower compared with the previously used definition (40.6 versus 57.5 percent).

"Expectations of patients and clinicians may have to be adjusted as regards [to] remission of type 2 diabetes after bariatric surgery," write the authors.

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