Remission of type 2 diabetes one year after esophagectomy with gastric conduit reconstruction: A prospective cohort study.

Background: Type 2 diabetes (T2D) remission has been widely reported after bariatric surgery, but rarely reported after esophagectomy.

Aim: To explore the incidence and predictors of T2D remission 1 year after esophagectomy with gastric conduit reconstruction.

Methods: In this prospective study, consecutive patients from 2 tertiary hospitals who had esophageal cancer and T2D and underwent esophagectomy with gastric conduit reconstruction were studied preoperatively and at 3 months, 6 months, and 12 months postoperatively. Remission of T2D is defined as glycated hemoglobin (HbA1c) values below 6.5% without glucose-lowering medications. Related clinical information were recorded and analyzed.

Results: A total of 187 patients were included. Of these patients, 24 (12.8%) discontinued antidiabetic drugs and maintained HbA1c values below 6.5% 1 year after surgery. At baseline, patients with T2D remission were younger (63.0 ± 5.2 years vs 67.0 ± 6.1 years, P = 0.002), had higher body mass index values (body weight 68.6 ± 11.1 kg vs 61.2 ± 9.3 kg, P = 0.001; body mass index 25.5 ± 2.4 kg/m² vs 23.8 ± 3 kg/m², P = 0.011), shorter duration of T2D (4.9 ± 3.9 years vs 7.1 ± 3.7 years, P = 0.008) and higher preoperative HbA1c (8.5% ± 1.7% vs 7.7% ± 1.3%, P = 0.042). Multivariate logistic regression analysis showed that younger age and greater body weight were independent predictors of T2D remission after surgery.

Conclusion: This study reveals a significant incidence of T2D remission after esophagectomy with gastric conduit reconstruction, and remission is more frequent in patients with younger age and greater body weight.