Metabolic Surgery Counseling, Diabetes Remission, and A1C Control in Patients with Diabetes and Obesity

• DOI: 10.2337/db18-2101-p
• Publication Date: 2018-06-22T18:57:33Z
• Authors: LEE-SHING CHANG; SHERVIN MALMASI; NAOSHI HOSOMURA; HUABING ZHANG; CHRISTOPHER J. BROWN; VICTOR J. LEI; ALEXA RUBIN; CLARA TING; KIMHOUY TONG; ALEXANDER TURCHIN
• Keywords: Demographics; Univariate analysis; Metabolic control analysis

Metabolic surgery (MS) can lower A1c and achieve DM remission. Counseling by a healthcare provider is an important initial step in considering MS. We hypothesized that MS counseling results significant increase remission improvement. retrospectively studied 3,676 adults aged 18-65 with T2DM, BMI ≥35 kg/m2, ≥6.5% followed at two academic medical centers between 2000-2015, using software tool to identify EMR notes. outcomes were assessed over one three years after study entry, respectively. Study patients’ mean age was 50.8 baseline 8.2%. Over year 20.2% of patients had counseling. In univariate analyses, who received higher rate (A1c<6.5% no medications besides metformin) more likely have achieved control (<7.0%) vs. those did not (Figure). multivariable analyses adjusted for patient demographics comorbidities, associated OR 1.43 (95% CI 1.11-1.84; p=.0051) achieving 1.44 1.15-1.81; p=.0015) control. this large T2DM obesity, significantly greater rates These findings suggest the treatment obesity. Disclosure L. Chang: None. S. Malmasi: N. Hosomura: H. Zhang: C.J. Brown: V.J. Lei: A. Rubin: C. Ting: K. Tong: Turchin: Research Support; Self; Sanofi-Aventis. Advisory Panel; Merck Sharp & Dohme Corp., Monarch Medical Technologies. Stock/Shareholder; Brio Systems. Eli Lilly Company.