Ahmadi Masseh Ahmad, Ojla Muhammad Dewan, Iqbal Maheen, Tahir Ayman, Nahar Noor Un, Hamza Muhammad, Amin Hajra
Internal Medicine, Shalamar Hospital, Lahore, PAK.
Internal Medicine, Fauji Foundation Hospital, Rawalpindi, PAK.
Cureus. 2025 Jun 22;17(6):e86539. doi: 10.7759/cureus.86539. eCollection 2025 Jun.
Background Type 2 diabetes mellitus (T2DM) is a prevalent metabolic disorder often associated with obesity. Despite conventional management strategies, many patients fail to achieve sustained remission. Objective This study aimed to investigate the role of metabolic bariatric surgery (MBS), specifically Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG), in achieving remission of T2DM and evaluating the effects on glycemic control and overall metabolic health in patients with obesity. Methods This retrospective study was conducted at Shalamar Hospital, Lahore, Pakistan from January 2021 to December 2024. Data for this study were collected from electronic medical records. It included glycated hemoglobin HbA1c) levels at baseline and subsequent intervals of three, six, and 12 months. Comparative analyses between the RYGB and SG groups were performed. Fasting blood glucose levels, use of antidiabetic medications (including both oral hypoglycemic agents and insulin), and anthropometric measurements such as weight and BMI were also tracked over time. To identify independent predictors of complete diabetes remission at 12 months, multivariate logistic regression analysis was performed. Results were reported as ORs with 95% CIs and Wald chi-square statistics. A p-value of <0.05 was considered statistically significant for all tests. Results At baseline, the mean age was 47.2 years, and the mean BMI was 42.6 kg/m². At three months, 38 of 81 (46.9%) patients achieved early glycemic response of T2DM. At six months, 21 of 81 (25.9%) showed partial response. By 12 months, complete remission was observed in 29 of 81 patients (35.8%). RYGB patients had higher rates than SG patients at both three months (25/43 (58.1%) vs. 13/38 (34.2%)) and 12 months (20/43 (46.5%) vs. 9/38 (23.7%)). Conclusions MBS, particularly RYGB, offers a highly effective treatment for T2DM in patients with obesity, with significant and sustained improvements in glycemic control and metabolic health. Early intervention, particularly in patients with shorter diabetes duration and lower preoperative HbA1c, maximizes the likelihood of achieving remission.
背景：2型糖尿病（T2DM）是一种常见的代谢紊乱疾病，常与肥胖相关。尽管有传统的管理策略，但许多患者未能实现持续缓解。目的：本研究旨在探讨代谢性减重手术（MBS），特别是Roux-en-Y胃旁路术（RYGB）和袖状胃切除术（SG）在实现T2DM缓解以及评估对肥胖患者血糖控制和整体代谢健康影响方面的作用。方法：本回顾性研究于2021年1月至2024年12月在巴基斯坦拉合尔的沙勒马尔医院进行。本研究的数据从电子病历中收集。包括基线时以及随后3个月、6个月和12个月时的糖化血红蛋白（HbA1c）水平。对RYGB组和SG组进行了比较分析。还随时间跟踪了空腹血糖水平、抗糖尿病药物（包括口服降糖药和胰岛素）的使用情况以及体重和BMI等人体测量指标。为了确定12个月时完全糖尿病缓解的独立预测因素，进行了多因素逻辑回归分析。结果以比值比（OR）及其95%置信区间（CI）和Wald卡方统计量报告。所有检验的p值<0.05被认为具有统计学意义。结果：基线时，平均年龄为47.2岁，平均BMI为42.6kg/m²。3个月时，81例患者中有38例（46.9%）实现了T2DM的早期血糖反应。6个月时，81例中有21例（25.9%）显示部分反应。到12个月时，81例患者中有29例（35.8%）观察到完全缓解。RYGB患者在3个月（25/43（58.1%）对13/38（34.2%））和12个月（20/43（46.5%）对9/38（23.7%））时的缓解率均高于SG患者。结论：MBS，尤其是RYGB，为肥胖患者的T2DM提供了一种高效的治疗方法，在血糖控制和代谢健康方面有显著且持续的改善。早期干预，特别是糖尿病病程较短和术前HbA1c较低的患者，可使实现缓解的可能性最大化。
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