Long-Term Remission Rate of Type 2 Diabetes Following Bariatric Surgery: A Retrospective Cohort Study in Adult Patients in Riyadh, Saudi Arabia.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL
Cureus Pub Date : 2025-01-02 eCollection Date: 2025-01-01 DOI:10.7759/cureus.76819
Bader Altulaihi, Ali M Sawlan, Nemer A Alwahbi, Bandar Alshahrani, Yazeed H Alrayani, Yazan H Alrayani
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Abstract

Introduction Type 2 Diabetes Mellitus (T2DM) is a chronic metabolic disorder that poses significant health and economic burdens, particularly in regions like Saudi Arabia where prevalence rates are among the highest globally. Bariatric surgery has emerged as a promising intervention, not only for weight reduction but also for inducing diabetes remission. However, while the short-term benefits of the procedure are well documented, long-term outcomes remain under-explored, especially in Saudi populations. This study aims to evaluate the long-term remission rates of T2DM and weight measurements following bariatric surgery in adult Saudi patients in Riyadh. Methods Using a retrospective cohort design, this study analyzes medical records of patients aged 18-65 who underwent bariatric surgery in the period of 2016-2020 and assesses Hemoglobin A1c (HbA1c) levels pre and post-surgery and diabetes remission using American Diabetes Association (ADA) criteria. The research also investigates factors influencing relapse rates and potential gender differences in remission outcomes. Results Out of 74 participants, the majority were females (53, 71.62%) compared to males (21, 28.37%). The mean BMI was recorded at 44.91 ± 6.68 kg/m2, indicating that participants generally fell within the obesity weight range. The mean HbA1c level prior to surgery was 8.70 ± 1.68, indicating suboptimal glycemic control at baseline. The mean HbA1c level decreased from 8.70 ± 1.68 before surgery to 6.76 ± 1.42 at the 12-month mark. The results indicated significant improvements in glycemic control post-surgery, as evidenced by the marked reduction in HbA1c levels at various time points (1 year, 2 years, etc.) with a p-value of 0.000. In terms of remission, the data showed a distinct result: out of 74 participants, only 20 participants (27%) achieved diabetes remission. Furthermore, seven participants (35%) out of the diabetic remission group experienced a relapse post-intervention and one participant achieved a second diabetes remission. In the assessment of risk factors for relapse, baseline BMI and gender were not strong factors in determining whether a patient experiences diabetes relapse post-surgery. As for weight measurements, the findings showed a steady increase in both Percent Excess Weight Loss (%EWL) and Percent Total Weight Loss (%TWL) in the initial years following surgery with no significant variations across the years, and the p-values were 0.710 and 0.446, respectively. For Percent Weight Regain (%WR), there was a significant and steady increase across the period, with values starting at 6.77 ± 11.8% at Year 2, increasing over the years, and peaking again at 26.64 ± 44.84% by Year 5, with a p-value of < 0.001. Conclusion This study is consistent with previous studies and provides compelling evidence that bariatric surgery leads to substantial improvements in glycemic control and weight reduction among Saudi patients with T2DM. However, it shows a lower percentage of remission in our participants compared to other local and global studies. Further local research is recommended to confirm our findings, analyze the reason for lower rates, and investigate the predictors of remission and relapse. This study fills a crucial gap in localized data, providing insights that could guide future healthcare strategies and improve the management of T2DM in the region.

减肥手术后2型糖尿病的长期缓解率:沙特阿拉伯利雅得成人患者的回顾性队列研究
2型糖尿病(T2DM)是一种慢性代谢性疾病,会造成严重的健康和经济负担,特别是在沙特阿拉伯等全球患病率最高的地区。减肥手术已经成为一种很有前途的干预手段,不仅可以减轻体重,还可以诱导糖尿病缓解。然而,尽管该手术的短期效益已得到充分证明,但长期效果仍未得到充分探讨,特别是在沙特人口中。本研究旨在评估利雅得成年沙特患者减肥手术后T2DM的长期缓解率和体重测量。方法采用回顾性队列设计,分析2016-2020年期间接受减肥手术的18-65岁患者的医疗记录,并根据美国糖尿病协会(ADA)标准评估手术前后血红蛋白A1c (HbA1c)水平和糖尿病缓解情况。该研究还调查了影响复发率的因素和缓解结果的潜在性别差异。结果74名参与者中,女性(53人,71.62%)多于男性(21人,28.37%)。平均BMI记录为44.91±6.68 kg/m2,表明参与者普遍处于肥胖体重范围内。术前平均HbA1c水平为8.70±1.68,表明基线血糖控制不理想。平均HbA1c水平从术前的8.70±1.68下降到12个月时的6.76±1.42。结果显示术后血糖控制有明显改善,各时间点(1年、2年等)HbA1c水平明显降低,p值为0.000。在缓解方面,数据显示了一个明显的结果:74名参与者中,只有20名参与者(27%)达到了糖尿病缓解。此外,糖尿病缓解组中有7名参与者(35%)在干预后复发,1名参与者实现了第二次糖尿病缓解。在评估复发的危险因素时,基线BMI和性别并不是决定患者术后是否糖尿病复发的重要因素。在体重测量方面,研究结果显示,在手术后的最初几年中,超额体重减轻百分比(%EWL)和总体重减轻百分比(%TWL)均稳步增加,各年之间无显著变化,p值分别为0.710和0.446。对于体重恢复百分比(%WR),在整个时期都有显著且稳定的增长,从第2年的6.77±11.8%开始,逐年增加,到第5年再次达到峰值26.64±44.84%,p值< 0.001。结论:本研究与先前的研究一致,并提供了令人信服的证据,表明减肥手术可显著改善沙特2型糖尿病患者的血糖控制和体重减轻。然而,与其他本地和全球研究相比,我们的参与者的缓解率较低。建议进一步的本地研究来证实我们的发现,分析低发病率的原因,并调查缓解和复发的预测因素。本研究填补了本地化数据的关键空白,为指导未来的医疗保健策略和改善该地区的T2DM管理提供了见解。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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