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. 2017 Mar;31(3):1172-1179.
doi: 10.1007/s00464-016-5087-3. Epub 2016 Jul 15.

Gastric bypass procedure for type 2 diabetes patients with BMI <28 kg/m2

Ke Gong  1 , Kai Li  2 , Nengwei Zhang  3 , Bin Zhu  2 , Dexiao Du  2 , Dongdong Zhang  2 , Zhen Zhang  2 , Jirun Peng  2
Affiliations

Gastric bypass procedure for type 2 diabetes patients with BMI <28 kg/m2

Ke Gong et al. Surg Endosc. 2017 Mar.

Abstract

Objectives: To evaluate the Roux-en-Y gastric bypass (GBP) procedure for patients suffering from type 2 diabetes mellitus (T2DM) with body mass index (BMI) <28 kg/m2.

Methods: Thirty-one patients suffering from T2DM were selected to undergo laparoscopic Roux-en-Y gastric bypass surgery and were enrolled at Beijing Shijitan Hospital between November 2012 and December 2014. The fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), C-peptide, fasting insulin (FINS) and glucagon-like peptide-1 (GLP-1) of all patients were measured before and at 1, 3, 6 months after surgery. The results were compared and analyzed.

Results: Thirty-one patients suffering from T2DM successfully underwent GBP surgery (a mean age of 46 years), 14 were male and 17 were female. Among them, 7 patients had hypertriglyceridemia (HTG). The patients were followed up for 6 months. No major complications were found. The average BMI was 26.5 ± 1.4 kg/m2 before surgery. The average levels of FPG, HbA1c, C-peptide, FINS of all patients were statistically decreased after surgery, respectively, compared to those before surgery (P < 0.05). However, the mean GLP-1 of all patients was statistically increased after surgery compared to that before surgery (P < 0.05). At 6 months after surgery, 22 patients (71 %) achieved complete remission of T2DM with HbA1c < 6.5 %, 7 patients (23 %) gained partial remission of T2DM with 6.5 % ≤ HbA1c < 7.0 % and 2 patients (6 %) experienced no remission of T2DM. The mean serum triglyceride of 31 patients was statistically decreased after surgery compared to that before surgery (P < 0.05).

Conclusions: This research shows that the GBP procedure is safe and effective for T2DM patients with BMI <28 kg/m2, and the condition of patients with HTG was greatly improved. However, further studies with larger samples and long-term follow-up are needed.

Keywords: Laparoscopic surgery; Low body mass index; Roux-en-Y gastric bypass; Type 2 diabetes mellitus.

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