Gastric bypass in the treatment of type 2 diabetes in patients with a BMI of 30 to 35 kg/m2.

BACKGROUND

Type 2 diabetes mellitus (T2DM) and class I obesity, which are pandemics of considerable socioeconomic importance, require new treatment modalities due to inadequate control through normal clinical conduct. The aim of the present study was to assess the efficacy and safety of Roux-en-Y gastric bypass (RYGB) in the control of T2DM in patients with a body mass index (BMI) of 30 to 35 kg/m(2).

METHODS

An observational, retrospective study was carried out at the Universidade Federal de Pernambuco-Brazil. Between 2002 and 2008, 27 patients were submitted to RYGB for the treatment of uncontrolled T2DM, with a mean follow-up period of 20 months. An assessment was performed of the complete resolution of T2DM [HbA(1c) < 6%/fasting plasma glucose (FPG) < 100 mg/dL/no diabetes medication] and glycemic control. The ethics committee of the university approved the study.

RESULTS

RYGB led to the following results: (1) 23% weight reduction (p < 0.001), BMI stabilized at 25.6 kg/m(2) in a mean of 12 months; (2) 46% reduction in glycemia and 27% reduction in HbA(1c) (p < 0.001); (3) 100% improvement in glycemia and 48% resolution of T2DM; (4) glycemic control was 74% without medication and 93% with medication and five patients required medication in addition to RYGB; (5) mean current FPG is 93 mg/dL and HbA(1c) is 6%; and (6) there were no severe complications or deaths.

CONCLUSIONS

RYGB is a safe and effective option in the treatment of uncompensated T2DM associated to class I obesity.