Effects of bariatric surgery on Type-2 Diabetes Mellitus in a Caribbean setting

Abstract

Objectives To determine if there is a beneficial effect of bariatric surgery in the management of Diabetes Mellitus in obese patients in a Caribbean setting. Methods A retrospective review of charts of all obese patients with Type-2 Diabetes Mellitus (DM) who had undergone Laparoscopic Roux en Y gastric bypass (LRYGBP) over a 4 year period was undertaken and clinical data recorded. A questionnaire was prospectively administered via telephone to determine the quality of life. Results Of 146 patients who underwent LRYGBP, 40 were found to have clinically significant DM. Patients of age < 50 years and females had a higher preponderance of DM. Patient body weight decreased significantly from a pre-operative131.2 ± 21.6 [Mean ± Standard Deviation (SD)] to 99.4 ± 16.6 after surgery ( p < 0.0001). There was also a significant reduction of BMI from 47.0 ± 7.9 to 34.7 ± 5.8 ( p < 0.0001). There was complete resolution of clinically significant DM in 85% of patients, while in 15% there was a significant reduction in the dosage of anti-diabetic medications. Perioperative complications were minimal and there was no mortality. 96% of the patients reported a drastic improvement in their quality of life. Conclusions Bariatric surgery for obese diabetic patients resulted in complete resolution, improved diabetes control and overall improvement in the quality of life. Due to better outcomes, the surgery can safely be recommended in the Caribbean multiethnic setting where there is a high prevalence of obesity and Diabetes Mellitus.