Mottin Cláudio Corá, Vontobel Padoin Alexandre, Schroer Caroline Eckerdt, Barancelli Fabiano Trentini, Glock Luiz, Repetto Giuseppe
Centro da Obesidade Mórbida-Hospital São Lucas da PUCRS COM HSL/PUCRS, Porto Alegre, Brazil.
Obes Surg. 2008 Feb;18(2):179-81. doi: 10.1007/s11695-007-9249-1. Epub 2008 Jan 4.
Surgical treatment of obesity has not only resulted in weight loss, but also the control of associated diseases in the postoperative period. The aim of this study was to determine the post-op response of type 2 diabetes mellitus (DM2) to gastric bypass.
A historical cohort study was performed involving all the diabetic, morbid obese patients who underwent gastric bypass during the period of May 2000 to October 2006 at the Centro da Obesidade Mórbida. Patient records were reviewed with regard to sex, age, anthropometric measurements, glycemia, glycosylated hemoglobin, pre-op insulin, and DM2 outcome.
A total of 125 diabetic, morbid obese patients were operated; they had a mean age of 42.6 +/- 9.7 years and body mass index of 49 +/- 8.3 kg/m2. Of these patients, 63 (50.4%) required medication for control of DM2, and the rest managed only with diet. Of these 63 patients, 43 (68.2%) achieved control of DM2 and were discharged without the need for antidiabetic medication, and 20 (31.7%) were discharged still on medication. One month after surgery, seven more patients discontinued medication for DM2, and 18 months after surgery, 97.6% of the patients showed control of DM2.
Gastric bypass is effective in controlling DM2 in morbid obese patients.
肥胖症的外科治疗不仅带来了体重减轻,还在术后阶段控制了相关疾病。本研究的目的是确定2型糖尿病(DM2)对胃旁路手术的术后反应。
进行了一项历史性队列研究,纳入了2000年5月至2006年10月期间在肥胖症中心接受胃旁路手术的所有糖尿病、病态肥胖患者。对患者记录进行了回顾,内容包括性别、年龄、人体测量学指标、血糖、糖化血红蛋白、术前胰岛素使用情况以及DM2的治疗结果。
共有125例糖尿病、病态肥胖患者接受了手术;他们的平均年龄为42.6±9.7岁,体重指数为49±8.3kg/m²。在这些患者中,63例(50.4%)需要药物来控制DM2,其余患者仅通过饮食控制。在这63例患者中,43例(68.2%)实现了DM2的控制,出院时无需使用抗糖尿病药物,20例(31.7%)出院时仍需用药。术后1个月,又有7例患者停止使用DM2药物,术后随访18个月时,97.6%的患者DM2得到控制。
胃旁路手术对控制病态肥胖患者的DM2有效。