Dynamics of type 2 diabetes mellitus laboratory remission after Roux-en-Y gastric bypass in patients with body mass index lower than 35 kg/m(2) and higher than 35 kg/m(2) in a 3-year observation period

INTRODUCTION: Bariatric surgery as treatment of type 2 diabetes mellitus (T2DM) in morbidly obese patients is becoming common. Although a large number of studies demonstrating high efficacy of bariatric methods in diabetics with body mass index (BMI) < 35 kg/m(2) have been published, this promising solution is still not accepted enough even in the era of a diabetes offensive. AIM: To analyze the dynamics of T2DM remission in patients with BMI < 35 kg/m(2) and > 35 kg/m(2) after Roux-en-Y gastric bypass (RYGB). MATERIAL AND METHODS: Data of 30 patients with BMI < 35 kg/m(2) and 82 with BMI > 35 kg/m(2) who underwent RYGB between 2007 and 2010 were collected from a prospectively designed database. The laboratory resolution of T2DM was determined by fasting plasma glucose (FPG ≤ 100 mg/dl) and glycosylated hemoglobin (HbA(1c) ≤ 6%). RESULTS: The T2DM regression was observed in 80% of the patients with BMI < 35 kg/m(2) and 83% in a group with BMI > 35 kg/m(2) 1 year after RYGB and about 80% 2 and 3 years after the operation in both groups. Normalization of average HbA(1c) and FPG was observed in the BMI > 35 kg/m(2) group after 3 months, while in the BMI < 35 kg/m(2) group it was reached 6 months postoperatively. Changes in main markers of T2DM were parallel with the BMI decrease 3–12 months after RYGB, but early resolution in some patients was observed independently of weight loss. CONCLUSIONS: The mid-term observation of patients after RYGB revealed the laboratory remission of T2DM. Ultimate evaluation of T2DM markers 3 years after surgery demonstrates high effectiveness of RYGB in managing T2DM in both groups.