Predictive factors of diabetes mellitus remission and weight regain

Abstract

Bariatric/metabolic surgery (BMS) is the most effective treatment for severe obesity. Still, as with all interventions, for weight loss, weight regain can occur with deleterious effects on comorbidities¹. Numerous studies have been conducted to understand the extent of weight regain after CBM. However, the reporting of weight regain varies widely among different studies, and the heterogeneity in these definitions hampers clinical research and conspires against a uniform epidemiologic assessment of the problem².

There are high rates of remission of comorbid conditions after MBC, most of which are evident in the first 2 years after surgery, followed by a decrease in remission from 5 years after surgery, especially for diabetes type 2 diabetes mellitus (DM2) and arterial hypertension (AHT)³. Although the exact mechanism for remission of DM2 after bariatric surgery is not fully understood, several have been proposed. One of these mechanisms involves reduced caloric intake which, in turn, leads to significant weight loss and subsequently improved glucose sensitivity. This was believed to be achieved through the restrictive and/or malabsorptive properties of MBC, however this does not explain some of the dramatic effects seen on glucose control immediately after surgery and therefore the Most of the glucose reduction is achieved before weight loss.