Evaluation of Type 2 Diabetes Mellitus in patients undergoing laparoscopic Roux EN Y gastric Bypass

Abstract

Objective: Objective: To establish the prevalence, remission and recurrence, according to the DiaRem, of type 2 diabetes mellitus in patients who underwent laparoscopic Roux-en-Y gastric bypass with follow-up for 3 years, in the bariatric surgery unit of the University Hospital of Caracas, period 2005-2015. Methods: A retrospective, descriptive, longitudinal study included 28 patients with diabetes mellitus who underwent laparoscopic Roux-en-Y gastric bypass. Results: The prevalence of diabetes mellitus was 12.4%. The characteristics of the patients on the DiaRem scale were: 85.7% did not use insulin, 50% were between 40-49 years old, 39.3% had glycosylated hemoglobin of 7%-8.9%, and 60.7% did not use sulfonylurea and insulin-sensitizing agents. The average score was 6.1 ± 4.8 (0–17). Remission at one year and three years was 78.6% and 71.4%, respectively. At 0-2 points, the sensitivity of DiaRem to predict remission at 1 and 3 years was 22.7% and 30.0%. Specificity was 83.3% at one year and 100% at 3 years [OR 1.5 (0.1-15.7) and 7.6 (0.4-152.8)]. The concordance between theoretical and actual remission was moderate and significant (1 year: k = 0.533; p = 0.001; 3 years: k = 0.543; p = 0.003). The 5-year recurrence rate was 31.8%. Conclusion: Bariatric surgery was associated with remission in more than 70% of patients, and the DiaRem scale may be useful in predicting non-remission in groups with lower scores.