Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: Comparison of BMI >35 and 2

Wei Jei Lee, Weu Wang, Yi Chih Lee, Ming Te Huang, Kong Han Ser, Jung Chien Chen

Research output: Contribution to journalArticle

179 Citations (Scopus)

Abstract

Laparoscopic gastric bypass resulted in significant weight loss and resolution of type 2 diabetes mellitus (T2DM). The current indication for bariatric surgery is mainly applied for patients with body mass index (BMI) >35 kg/m2 with comorbidity status. However, little is known concerning T2DM patients with BMI 2. Recent studies have suggested that T2DM patients with BMI 2 might benefit from gastric bypass surgery. From Jan 2002 to Dec 2006, 820 patients who underwent laparoscopic mini-gastric bypass were enrolled in a surgically supervised weight loss program. We identified 201 (24.5%) patients who had impaired fasting glucose or T2DM. All the clinical data were prospectively collected and stored. Patients with BMI 2 were compared with those of BMI >35 kg/m2. Successful treatment of T2DM was defined by HbA1C 2, and 114 (56.7%) had BMI between 35and 45, 43 (21.4%) had BMI >45 kg/m2. Patients with BMI 2 are significantly older, female predominant, had lower liver enzyme and C-peptide levels than those with BMI >35 kg/m2. The mean total weight loss for the population was 32.1, 33.4, 31.9, and 32.8% (at 1, 2, 3, 5 years after surgery), and percentage to change in BMI was 31.9, 34.2, 32.2, and 29.5% at 1, 2, 3, and 5 years. One year after surgery, fasting plasma glucose returned to normal in 89.5% of BMI 2 T2DM and 98.5% of BMI >35 kg/m2 patients (p∈=∈0.087). The treatment goal of T2DM (HbA1C 2 and 92.4% of BMI >350 kg/m2 (p∈=∈0.059). Laparoscopic gastric bypass resulted in significant and sustained weight loss with successful treatment of T2DM up to 87.1%. Despite a slightly lower response rate of T2DM treatment, patients with BMI

Original languageEnglish
Pages (from-to)945-952
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume12
Issue number5
DOIs
Publication statusPublished - May 2008

Keywords

  • Bariatric surgery
  • BMI <35
  • Type 2 DM

ASJC Scopus subject areas

  • Surgery

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