Preoperative Use of Incretins Is Associated With Increased Diabetes Remission After RYGB Surgery Among Patients Taking Insulin. Issue 1 (January 2015)

• Record Type: Journal Article
• Authors: Wood, G. Craig; Gerhard, Glenn S.; Benotti, Peter; Petrick, Anthony T.; Gabrielsen, Jon D.; Strodel, William E.; Ibele, Anna; Rolston, David D.; Still, Christopher D.; Argyropoulos, George
• Is Part Of: Annals of surgery. Volume 261:Issue 1(2015:Jan.)
• Publication Date: 2015-01
• Subjects: Surgery -- Periodicals; 617.005
• DOI: 10.1097/SLA.0000000000000588
• Languages: English
• ISSNs: 0003-4932

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective:</title> <p>The main goal of this study was to determine the effects of incretins on type 2 diabetes (T2D) remission after Roux-en-Y gastric bypass (RYGB) surgery for patients taking insulin.</p> </sec> <sec> <title>Background:</title> <p>Type 2 diabetes is a chronic disease with potentially debilitating consequences. RYGB surgery is one of the few interventions that can remit T2D. Preoperative use of insulin, however, predisposes to significantly lower T2D remission rates.</p> </sec> <sec> <title>Methods:</title> <p>A retrospective cohort of 690 T2D patients with at least 12 months follow-up and available electronic medical records was used to identify 37 T2D patients who were actively using a Glucagon-like peptide 1 (GLP-1) agonist in addition to another antidiabetic medication, during the preoperative period.</p> </sec> <sec> <title>Results:</title> <p>Here, we report that use of insulin, along with other antidiabetic medications, significantly diminished overall T2D remission rates 14 months after RYGB surgery (9%) compared with patients not taking insulin (56%). Addition of the GLP-1 agonist, however, increased significantly T2D early remission rates (22%), compared with patients not taking the GLP-1 agonist (4%). Moreover, the 6-year remission rates were also significantly higher for the former group of patients. The GLP-1 agonist did not improve the remission rates of diabetic patients not taking insulin as part of their pharmacotherapy.</p> </sec> <sec> <title>Conclusions:</title> <p>Preoperative use of antidiabetic medication, coupled with an incretin agonist, could significantly improve the odds of T2D remission after RYGB surgery in patients also using insulin.</p> </sec> </abstract>