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 20 May 2018

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News

Effect of laparoscopic Roux-en Y gastric bypass on diabetes

Laparoscopic Roux-en Y gastric bypass results in significant weight loss and resolution of type 2 diabetes mellitus, find doctors in the October issue of Annals of Surgery.

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The surgical treatment of morbid obesity leads to dramatic improvement in the comorbidity status of most patients with type 2 diabetes mellitus (T2DM).

In this study, doctors from the United States evaluated the parameters associated with this improvement following laparoscopic Roux-en-Y gastric bypass (LRYGBP) in patients with T2DM.

The team assessed 191 patients (144 female, mean age 48 years) with impaired fasting glucose (IFG) and type T2DM who underwent LRYGBP between 1997 and 2002.

They evaluated pre- and postoperative data, including demographics, duration of diabetes, metabolic parameters, and clinical outcomes.
Fasting plasma glucose returned to normal levels in 83% of patients.
Annals of Surgery

The doctors found that patients' weight and body mass index decreased from 308 lbs and 50.1 kg/m2 to 211 lbs and 34 kg/m2. This was a mean weight loss of 97 lbs and a mean excess weight loss of 60%.

In addition, fasting plasma glucose and glycosylated hemoglobin concentrations returned to normal levels in 83% of patients and markedly improved in 17%.

Furthermore, there was a significant reduction in use of oral antidiabetic agents and insulin following treatment.

The team found that patients with the shortest T2DM duration, the mildest form, and the greatest weight loss after surgery were most likely to achieve complete resolution of T2DM.

Dr Philip Schauer's team concluded, "LRYGBP resulted in significant weight loss (60% of excess body weight loss) and resolution (83%) of T2DM".

"Patients with the shortest duration and mildest form of T2DM had a higher rate of T2DM resolution after surgery, suggesting that early surgical intervention is warranted to increase the likelihood of rendering patients euglycemic".

Ann Surg 2003; 238(4): 467-85
09 October 2003

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