Long-Term Follow-up of the Metabolic Profiles in Obese Patients With Type 2 Diabetes Mellitus After Roux-en-Y Gastric Bypass

Objective: The goal of this study was to evaluate the effect of Roux-en-Y gastric bypass (RYGBP) on 2 metabolic disorders, diabetes and dyslipidemia, in obese type 2 diabetes mellitus (T2DM) patients. Summary Background Data: Little is known about the long-term change in metabolic and lipid profiles of T2DM patients after RYGBP. Methods: This is a retrospective review of prospectively collected data about glucose metabolism and lipid profiles of morbidly obese patients with T2DM on antidiabetic medications who underwent laparoscopic RYGBP. Results: A total 219 patients with mean (+/- SD) duration of follow-up of 26.4 (+/- 12.8) months were included in the study. At one year postoperative mean serum fasting plasma glucose fell from 152.8 to 106.0 mg/dL, HGBA1c (glycated hemoglobin) fell from 7.6% to 6.1%, TC (total cholesterol) went from 180.9 to 172.0 mg/dL, TG (triglyceride) fell from 208.0 to 117.4 mg/dL, and HDL-C (HDL-cholesterol) levels increased from 48.7 to 58.7 mg/dL. These improvements were maintained 2 to 4 years after surgery. Older age, longer duration of T2DM, and insulin use were important preoperative factors associated with failure to resolve T2DM. Postoperatively, the amount of total weight loss was associated with the improvement or resolution of T2DM (P = 0.053). Conclusion: Laparoscopic RYGBP has a beneficial effect on glucose metabolism and serum lipid composition in obese T2DM patients. Sustained weight loss was associated with maintenance of euglycemia in postoperative obese T2DM patients.