Type 2 diabetes remission after Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and one anastomosis gastric bypass (OAGB): results of the longitudinal assessment of bariatric surgery study.

BACKGROUND: Several studies on various bariatric surgeries involving patients with type 2 diabetes mellitus (T2DM) showed an overall rate of remission of hyperglycemia. However, there is little known about predictive factors on remission after different types of surgeries. The aim of this study was to identify the T2DM remission rate and to determine the effects of preoperative factors characteristics of remission of type 2 diabetes in Iran. METHODS: We conducted a retrospective analysis of 1351 patients with T2DM operated by three different types of surgeries (Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and One Anastomosis Gastric Bypass (OAGB)). Diabetes remission was defined according to the American Diabetes Association (ADA) criteria. Binary logistic regression analyses were employed. RESULTS: A total of 1351 patients, 675 patients (50.0%) undergoing OAGB, 475 (35.2%) RYGB, and 201 (14.9%) SG. 80.6%, 84.2% of OAGB, 81.7%, 82.6% of RYGB, and 77.1%, 81.5% of SG participants were in T2DM remission after 1 and 3 years, respectively. 1- and 3-year remission were associated with preoperative age, duration of T2DM, FBS and HbA1c, BMI, insulin therapy, and a family history of obesity (p < 0.05). CONCLUSION: The remission of T2DM after RYGB, SG, and OAGB surgery is dependent on various preoperative factors. Patients with younger age, shorter duration of T2DM, lower preoperative HbA1c and FBS, higher BMI, who were not on insulin therapy, and not having a family history of obesity were the best candidates to achieve a prolonged diabetes remission.

Gender-related differences in upper gastrointestinal endoscopic findings: an assessment of 4,700 cases from Iran.

BACKGROUND AND OBJECTIVE: Regarding the high prevalence of gastrointestinal symptoms in our country, the probable overuse or even late usage of upper gastrointestinal endoscopy for unnecessary reasons and gender influences on both internal and external fate and effects, we decided to evaluate the gender-related differences in upper gastrointestinal endoscopic findings to provide gastroenterologists with information which they can perform better interpretation of their patient's symptoms before performing upper gastrointestinal endoscopy. DESIGN: A descriptive cross-sectional study performed to evaluate gender-related differences in the upper endoscopy findings. SETTING: The study was performed in the upper endoscopy ward of a general hospital in Tehran, Iran. PATIENTS: Four thousand and seven hundred Iranian patients undergo upper endoscopy between 1992 and 2002. MAIN OUTCOME MEASUREMENTS: Upper endoscopy findings RESULTS: After age adjustment, oesophageal tumour, gastroesophageal reflux disease (GERD), gastric tumour, oesophageal varices, gastritis, hiatal hernia, gastric ulcer and erosive gastropathy, all p < 0.001 were significantly more common among men rather than women. Male gender predicts the presence of hiatal hernia (odds ratio (OR) = 1.9, p < 0.001), GERD (OR = 1.6, p < .001), gastric ulcer (OR = 2.3, p < 0.001), duodenal ulcer (OR = 2.3, p < 0.001) and duodenal varices (OR = .6, p = .044). LIMITATION: Backward study CONCLUSION: Our regression models revealed that male gender is a risk factor for hiatal hernia, GERD, gastric ulcer and duodenal ulcer but not for other upper endoscopic findings.