Diabetes remission after bariatric surgery

Table 1 Bariatric surgery vs medical management for type 2 diabetes mellitus remission

Ref.	Pts w/ follow up/enrolled pts	Study duration, years	Medical management T2DM resolution %	RYGB T2DM resolution %	SG T2DM resolution %	BPD-DS T2DM resolution %	AGB T2DM resolution %	T2DM resolution definition	P value
Mingrone et al[12], 2012	56/60	2	0	75	N/A	95	N/A	FPG < 100 mg/dL + HbA1c < 6.5 mmol/L + no pharmacotherapy	< 0.05
Cummings et al[21], 2016	43/43	1	6	60	N/A	N/A	N/A	HbA1c < 6% + no pharmacotherapy	< 0.05
Schauer et al[22], 2017	134/150	5	5	29	23	N/A	N/A		< 0.05
Hofsø et al[23], 2019	107/109	1	N/A	74	47	N/A	N/A		< 0.05
Courcoulas et al[11], 2020	50/61	5	0	30	N/A	N/A	19		< 0.05
Mingrone et al[24], 2021	57/60	10	5	25	N/A	50	N/A		< 0.05

T2DM: Type 2 diabetes mellitus; RYGB: Roux-en-Y gastric bypass; SG: Sleeve gastrectomy; BPD-DS: Biliopancreatic diversion with duodenal switch; AGB: Adjustable gastric banding; FPG: Fasting plasma glucose; HbA1c: Glycocylated hemoglobin.

Table 2 Predictors of diabetes mellitus remission following bariatric surgery

	Diarem	Diarem2	IMS	ABCD	Duke diabetes remission
Procedure	Rygb	RYGB	RYGB or SG	RYGB or mini-gastric	RYGB, SG, AGB, BPD/DS
Number of patients (n)	690	307	659	63	602
Variables	Insulin use	Insulin use	Insulin use	Diabetes duration	Age
					Sex
	Age	Age	Duration of diabetes	Age	Race
					Insulin use
	Hba1c	Hba1c	Hba1c	Baseline BMI	Hba1c
					BMI
	Type of antidiabetic drugs	Duration of diabetes	Number of diabetic medications	C-peptide level	Preop asthma, GERD, hypertension, hyperlipidemia, anticoagulation medication status
					Type of antidiabetic drugs
Scale	0-22 (5 groups)	0-25 (High-Intermediate-Low remission)	3 stages (Mild-Moderate-Severe)	0-10	Odds of remission according to preoperative variables and type of surgery
Recommendation on procedure of choice	No	No	Yes	No	No

RYGB: Roux-en-Y gastric bypass; SG: Sleeve gastrectomy; BPD-DS: Biliopancreatic diversion with duodenal switch; AGB: Adjustable gastric banding; HbA1c: Glycosylated hemoglobin; GERD: Gastroesophageal reflux disease.