Impacts of bariatric surgery on type 2 diabetes mellitus

Mohamed A Yassin ,Issam Merdan ,Falih Mohsen Algazgooz

doi:10.33762/mjbu.2019.163355

Abstract

Objective: To determine the beneficial effect of bariatric surgery on the treatment of type 2 diabetes mellitus in obese patients.Patients and methods: This prospective study was conducted in Al-Sader teaching hospital and Al-Musawi privet hospital from August 2013 to August 2017 on 332 patients with body mass index between 35-55, their age was range from 30-60 years, and they were 185 (55.7%) females and 147 (44.3%) males. All patients in this study were diabetic type 2 with different stages of the disease, types of medications, C peptide levels, HbA1c and BMI. They were subjected to three different bariatric procedures; laparoscopic sleeve gastrectomy (LSG), mini gastric bypass (MGB), and laparoscopic Roux-en-Y gastric bypass (LRYGB), they were followed for a period of 1-4 years regarding their glycemic control, HbA1c, type and number of medications.Results: Three hundred and thirty two patients were included in this study, 111 patients (33.5%) had MGB, 88 patients (26.5%) had LRYGB, 133 patients (40%) had LSG according to the following selection criteria; duration and severity of DM, C peptide, other comorbidities and the patients preference Resolution of DM was achieved in 100 patient (90%) of MGB, 77 patient (87%) of LRYGB and 75 patient (57%) of LSG while other patients had no improvement. Conclusion: Bariatric surgery for obese diabetic patients resulted in complete resolution in most patients, improvement of diabetes in some and overall improvement in the quality of life in all patients.

Highlights

The increasing prevalence of obesity in adult population triggered a concomitant rise in type 2 diabetes mellitus (T2DM).[1,2] Obesity and insulin resistance are the main components of metabolic syndrome and result in impaired glucose metabolism
This study showed that average level of HbA1c, fasting blood glucose and clinical outcome of comorbidities are much better than conventional and intensive medical therapy
Improvement of diabetes after laparoscopic Roux-en-Y gastric bypass (LRYGB) and mini gastric bypass (MGB) surgery occur after early days of surgery independent to weight loss, surgically induce hormonal changes and post-operative diet restriction are the proposed mechanisms while after laparoscopic sleeve gastrectomy (LSG) surgery, the glycemic control tooks longer time

Summary

INTRODUCTION

The increasing prevalence of obesity in adult population triggered a concomitant rise in type 2 diabetes mellitus (T2DM).[1,2] Obesity and insulin resistance are the main components of metabolic syndrome and result in impaired glucose metabolism. [18] Changes are seen in adipocyte derived hormones, leptin is correlated with insulin resistance whereas adeponectin enhance insulin sensitivity, after bypass surgery, a decrease in leptin and increase in adeponectin level are observed.[19] This study aimed to determine the valuable effects of bariatric surgery on the treatment of type 2 diabetes mellitus in obese patients This prospective study included 332 morbidly obese patients who are a known cases of type 2 diabetes who underwent bariatric procedures by the same surgeon in both Al-Sader Teaching Hospital and Al-Musawi Privet Hospital from August 2013 to August 2017. The mean postoperative follow-up was 2 years (from 1-4 years)

RESULTS

DISCUSSION

484. Discussion