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Aims/Introduction  Little is known about the long‐term effects of Roux‐en‐Y gastric bypass ( RYGB ) in severely obese Asian individuals.    Methods and Materials  A total of 33 severely obese patients with type 2 diabetes underwent  RYGB . All patients were followed up for 2 years. Visceral and abdominal subcutaneous fat areas were assessed using computed tomography ( CT ) before, and 12 and 24 months after  RYGB . The muscle attenuation ( MA ) of paraspinous muscles observed by  CT  were used as indices of intramuscular fat.    Results  The mean percentage weight loss was 22.2 ± 5.3% at 12 months, and 21.3 ± 5.1% at 24 months after surgery. Compared with the baseline values, the visceral fat area was 53.6 ± 17.1% lower 24 months after surgery, and the abdominal subcutaneous fat area was 32.7 ± 16.1% lower 24 months after surgery. The  MA  increased from 48.7 ± 10.0 at baseline to 52.2 ± 8.9 ( P  = 0.009) 12 months after surgery. The  MA  after the first 12 months maintained changes until 24 months. Triglycerides and free fatty acids were reduced after surgery, whereas the high‐density lipoprotein cholesterol levels were increased significantly after surgery. At the last follow‐up visit, 18 patients (55%) had diabetes remission. The percentage of iron and vitamin D deficiency was 30% and 52%, respectively.    Conclusions  We found that patients subjected to  RYGB  had significant sustained reductions in visceral and intramuscular fat. There were durable improvements in the cardiometabolic abnormalities without any significant comorbidities. However, there were mild nutritional deficiencies in these patients despite daily supplementation with multivitamins and minerals.

journal of diabetes investigation

Effects of bariatric surgery on metabolic and nutritional parameters in severely obese  K orean patients with type 2 diabetes: A prospective 2‐year follow up