Type 2 Diabetes Mellitus in Patients with Mild Obesity: Preliminary Results of Surgical Treatment

Abstract

In the last years, type 2 diabetes mellitus (T2DM) and obesity have become a serious public health problem, behaving as epidemic diseases. There is great interest in exploring different options for the treatment of T2DM in nonmorbidly obese patients. The purpose of this study is to report parameters of glycemic control in patients with T2DM and mild obesity who underwent laparoscopic Roux-en-Y gastric bypass (RYGBP). This prospective clinical trial includes patients with T2DM with a body mass index (BMI) between 30 and 35 kg/m(2) who underwent laparoscopic RYGBP from July 2008 through October 2010. Thirty-one patients were included in the study, 15 men and 16 women, with an average age of 48.7 ± 8.6 years. The average time since onset of T2DM was 5.8 years. The average postoperative follow-up was 30.4 months. The average preoperative blood glucose and glycosylated hemoglobin were 152 ± 70 mg/dl and 7.7 ± 2.1 %, respectively. All of them were using oral hypoglycemic agents, and four patients were insulin dependent. Only one patient had a postoperative complication (hemoperitoneum). At 36 months follow-up, the average BMI decreased to 24.7 kg/m(2), all patients (31) showed improvement in their glycemic control, and 29 of them (93.6 %) met the criteria for remission of T2DM in the last control. Laparoscopic RYGBP is a safe and effective procedure that improves glycemic control in patients with T2DM and mild obesity at midterm follow-up.

Preoperative prediction of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a retrospective cohort study

“…Preoperative BMI was recently proposed as an inappropriate selection criterion for offering RYGB surgery 24 as a means for resolving diabetes even for patients with low BMI (25–35 Kg/m 2 ). 25 In agreement with this notion, our weighting system did not find preoperative BMI as a sufficiently strong predictor and therefore it was not included in the DiaRem Score.…”

The effect of long Roux-en-Y gastrojejunostomy in gastric cancer patients with type 2 diabetes and body mass index & 35 kg/m2: preliminary results

“…However, bariatric surgery as a treatment for T2DM in mildly obese (BMI < 35 kg/m 2 ) or nonobese patients has more recently become of matter of intense debate. While relevant studies are few, there is mounting evidence for similar benefits of gastrointestinal metabolic surgery on diabetes in patients with BMI < 35 kg/m 2 [ 6 , 7 , 8 ]. Various b ariatric surgery approaches have been proposed in the literature for the treatment of T2DM in mildly obese and non-obese patients.…”

Impact of Roux-en-Y Gastric Bypass Surgery (Rygb) on Metabolic Syndrome Components and on the Use of Associated Drugs in Obese Patients

“…In a study by Lanzarini et al (14) , all patients who underwent bariatric surgery with gastric bypass exhibited improved glycemic control, and 93.6% met the criteria for T2DM remission. This study involves patients who underwent bypass surgery from July 2008 to October 2010 at the University Hospital of Santiago de Chile, with a 24-month followup.…”