The outcome results in patients with type 2 diabetes mellitus and obesity after either adjustable gastric banding (AGB) or Roux-en-Y (RNY) gastric bypass

Abstract

The prevalence of the type 2 diabetes and obesity are on the rise globally. Initial interventions for these groups of patients remain diet, exercise and medications. If these measures are insufficient gastrointestinal surgery offers a very good alternative for obesity and type 2 diabetes treatment. We report the outcome results for patients who underwent either adjustable gastric banding (AGB) or Roux-en-Y (RNY) gastric bypass in the years 2009-2012. Out of 33 patients (7 men, 26 women, average age 48.4 yrs), 11 underwent AGB and 22 had RNY. Preoperatively there were no statistically significant differences in: weight, excess of weight, Body Mass Index (BMI), HbA1c, blood pressure between AGB and RNY subgroups. In the AGB subgroup the following results were obtained 6 months after the operation: average loss of weight (LOW) 10.87 kg, 18.18 % achieved 50% estimated weight loss (EWL), 0 % achieved 70% EWL. We observed HbA1c reduction of 5.66 mmol/mol. 12 months after the operation average LOW was 14.8 kg, 9.09 % achieved 50% EWL, 0 % achieved 70% EWL. We observed HbA1c reduction of 7.41 mmol/mol and reduction in BP of 9.6/5.6 mmHg. In the RNY subgroup 6 months after operation the results were as follows: average LOW 30.9 kg, 71.43 % achieved 50% EWL, 23.81 % achieved 70% EWL. We observed HbA1c reduction of 24.1 mmol/mol. 12 months after the operation average LOW was 39.95 kg, 100 % achieved 50% EWL, 58.33 % achieved 70% EWL. We observed HbA1c reduction of 13.27 mmol/mol. We observed overall reduction in BP 12.5/4.95 mmHg The results show significantly better achievement of EWL and reduction in HbA1c in the RNY subgroup. These results were more sustainable in RNY group 12 months after the operation. Our report supports the more favourable outcomes in patients undergoing RNY gastric bypass procedures.