P2614 - The Association Between Diabetes Microvascular Complications and Type-2 Diabetes Remission in Patients Undergoing Roux-En-Y Gastric Bypass or Sleeve Gastrectomy
Wissam Ghusn, MD, Marita Salame, MD, Karl Hage, MD, Andres Acosta, MD, PhD, Todd Kellogg, MD, Barham Abu Dayyeh, MD, MPH, Omar Ghanem, MD Mayo Clinic, Rochester, MN
Introduction: Obesity is a chronic and multifactorial disease that is associated with type-2 diabetes mellitus (T2DM). T2DM results in serious cardiovascular complications (e.g., microvascular diseases) which elevates the morbidity and mortality risks. Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) are the most effective weight loss strategies that enhance T2DM remission (DR), resulting in a significant decrease in mortality risk in this population. However, limited data are present regarding the effect of having microvascular diabetes complications on DR in patients undergoing RYGB or SG. We hypothesized that patients with microvascular complications have a lower DR rate.
Methods: We performed a retrospective cohort study in patient with T2DM and have undergone RYGB or SG. We collected data on preoperative diabetes microvascular complications including retinopathy, nephropathy, and neuropathy. Our primary end point was assessing an association between the presence of microvascular complications and DR. Our secondary end points included evaluating an association between each type of complications independently with DR, and assessing a cumulative effect of these complication on disease remission. We analyzed our continuous data using a 2-sample independent t test and categorical data using chi squared test. Data are presented as mean ± standard deviation (SD).
Results: A total of 536 patients (66% female, 93% White, mean age 53.7 [10], BMI 46.2 [9] kg/m2) are included in this study (Table 1). Out of these patients, 239 (45%) had microvascular complications with the most common being neuropathy (n= 216; 40%). Patients with any microvascular complication had a significantly lower DR rate of 29.7% compared to patients without any complication (57.6%; p< 0.001; Figure 1A). In addition, patients with retinopathy had a DR rate of 15.6% vs 51.1% in patients without retinopathy, with nephropathy 21.6% vs 53.3% in patients without nephropathy, and with neuropathy 31.0% vs 54.7% in patients without neuropathy (p< 0.001 for all comparisons). Importantly, there was an additive effect of the number of microvascular complications on the DR rate (p< 0.001; Figure 1B).
Discussion: In this study, patients with T2DM microvascular complications had a lower DR rate after RYGB and SG. Hence, a more aggressive management might be needed in this cohort of patients in addition to the weight loss achieved by bariatric surgery.
Figure: Figure 1: T2DM remission in patients with/without microvascular complications (A) and the additive effect of these complications on the rate of remission (B).
Disclosures:
Wissam Ghusn indicated no relevant financial relationships.
Marita Salame indicated no relevant financial relationships.
Karl Hage indicated no relevant financial relationships.
Andres Acosta: Amgen Pharmaceuticals – Consultant. General Mills – Consultant. Gila Therapeutics – Stock-privately held company. Phenomix Sciences – Stock-privately held company. Rhythm Pharmaceuticals – Consultant.
Todd Kellogg indicated no relevant financial relationships.
Barham Abu Dayyeh: Apollo Endosurgery – Consultant, Grant/Research Support. Aspire Bariatrics – Grant/Research Support. Boston Scientific – Consultant, Grant/Research Support. Cairn Diagnostics – Grant/Research Support. DyaMx – Consultant. Endogastric Solutions – Speakers Bureau. Endo-TAGSS – Consultant. GI Dynamics – Grant/Research Support. Johnson and Johnson – Speakers Bureau. Medtronic – Grant/Research Support. Olympus – Speakers Bureau. Spatz Medical – Grant/Research Support. USGI Medical – Consultant, Grant/Research Support.
Omar Ghanem indicated no relevant financial relationships.
Wissam Ghusn, MD, Marita Salame, MD, Karl Hage, MD, Andres Acosta, MD, PhD, Todd Kellogg, MD, Barham Abu Dayyeh, MD, MPH, Omar Ghanem, MD. P2614 - The Association Between Diabetes Microvascular Complications and Type-2 Diabetes Remission in Patients Undergoing Roux-En-Y Gastric Bypass or Sleeve Gastrectomy, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
