Roux-en-Y Gastric Bypass for T2D Treatment in Chinese Patients with Low BMI: 5-Year Outcomes

Background RYGB was considered as an effective treatment for obese patients with T2D. However, 5-year outcomes including T2D remission after surgery have not been adequately studied in Chinese patients. Objectives Our aim is to evaluate metabolic outcomes of RYGB in 5-year follow-up. Methods We retrospectively divided 59 Chinese patients into two groups, namely BMI groups (group A: BMI < 28 kg/m(2); group B: BMI >= 28 kg/m(2)) and A1C groups (group C: A1C < 7%; group D: A1C >= 7%). Their medical records were collected and cardiovascular risk and medications were evaluated in 5 years after RYGB. Results Thirty patients were female (30/59, 50.85%). RYGB was performed laparoscopically without mortality or major complications. The mean BMI in 59 patients decreased from 30.89 +/- 3.12 to 25.04 +/- 3.48 in the fifth year. No one was lost to follow-up in 5 years. There were significant reductions in BMI, A1C, and oral medication or insulin in all groups. Diabetes remission rates in the first, third, and fifth years postoperation were 77.97, 61.02, and 49.15%. T2D relapse and requirement for antihypertensive agents increased in the third and fifth years. Larger quantity of subcutaneous fat area (SFA) and shorter duration of T2D preoperation were more likely to achieve remission of T2D postoperation. Conclusions This study has confirmed that RYGB is an effective treatment for obese Chinese patients with T2D, resulting in diabetes remission, metabolic disorder control, and cardiovascular risk reduction.