New metrics to assess type 2 diabetes after bariatric surgery: The “time-within-remission range”

A. De Hollanda, A. Lecube, M. Angel Rubio, E. Sánchez, N. Vilarrasa, J.G. Oliva, M.L. Fernández-Soto, J. Salas-Salvadó, M.D. Ballesteros-Pomar, A. Ciudin, F. Torres, C. Vidal, M.J. Morales, S. Valdés, S. Pellitero, I. Miñambres, L. Masmiquel, A. Goday, L. Suarez, L. FloresM. Bueno, A. Caixàs, I. Bretón, R. Cámara, R. Olbeyra, R. Penso, M.J. De La Cruz, A. Simó-Servat, F.M. Pereyra-García, E.T. López-Mezquita, A. Gils, E. Fidilio, O. Bandrés, Á. Martínez, J. Abuín, M. Marques-Pamies, L. Tuneu, M. Arteaga, O. Castañer, F. Goñi, C. Arrizabalaga, M.A. Botana, A. Calañas, Á. Rebollo

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4 Citations (Scopus)


Almost one third of patients do not achieve type 2 diabetes remission after bariatric surgery or are unable to sustain this effect long term. Our objective was to delve further into the dynamic responses of diabetes after bariatric surgery and to evaluate the “time-within-remission range” as a variable of metabolic control. A descriptive cohort study was done using a computerised multicentre and multidisciplinary registry. All data were adjusted by propensity score. A total of 1186 subjects with a follow-up of 4.5 ± 2.5 years were included. Type of surgery, diabetes remission, recurrence of diabetes, “time-within-remission range” and key predictors of diabetes outcomes were assessed. All patients (70% women, 51.4 ± 9.2 years old, body mass index (BMI) 46.3 ± 6.9 kg/m2) underwent primary bariatric procedures. “Time-within-remission range” were 83.3% (33.3- 91.6) after gastric bypass, 68.7% (7.1-87.5) after sleeve gastrectomy and 90% (83.3-92.8) after malabsorptive techniques (p < 0.001 for all). Duration of diabetes, baseline HbA1c and insulin treatment were significantly negatively correlated with the “time-within-remission range”. The association of bariatric techniques with “time-within-remission range”, using gastric bypass as a reference, were: odds ratio (OR) 3.70 (2.34-5.84), p < 0.001 for malabsorptive techniques and OR 0.55 (0.40-0.75), p < 0.001 for sleeve gastrectomy. Characteristics of type 2 diabetes powerfully influence the outcomes of bariatric surgery. The “time-within-remission range” unveils a superiority of gastric bypass compared to sleeve gastrectomy. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.
Original languageEnglish
Article number1070
Number of pages13
JournalJ. Clin. Med.
Issue number4
Publication statusPublished - 9 Apr 2020


  • Bariatric surgery
  • Metabolic control
  • Time-within-remission range
  • Type 2 diabetes
  • antidiabetic agent
  • glucose
  • hemoglobin A1c
  • high density lipoprotein cholesterol
  • hyperglycemic agent
  • insulin
  • low density lipoprotein cholesterol
  • triacylglycerol
  • adult
  • anthropometric parameters
  • antidiabetic activity
  • Article
  • bariatric surgery
  • body mass
  • body weight gain
  • body weight loss
  • cohort analysis
  • descriptive research
  • diabetes mellitus
  • disease duration
  • dyslipidemia
  • female
  • follow up
  • gastric bypass surgery
  • human
  • hypertension
  • insulin dependent diabetes mellitus
  • insulin treatment
  • major clinical study
  • male
  • metabolic regulation
  • middle aged
  • morbidity
  • non insulin dependent diabetes mellitus
  • obesity
  • outcome assessment
  • propensity score
  • recurrent disease
  • remission
  • retrospective study
  • risk factor
  • sleeve gastrectomy
  • metabolic control
  • time-within-remission range
  • type 2 diabetes


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