Universidade Federal de Pernambuco, Recife, Brazil.
Obes Surg. 2011 Mar;21(3):283-7. doi: 10.1007/s11695-010-0318-5.
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).
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.
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.
RYGB is a safe and effective option in the treatment of uncompensated T2DM associated to class I obesity.
2 型糖尿病（T2DM）和 I 类肥胖症是具有相当重大社会经济意义的流行病，由于正常临床治疗的控制不足，需要新的治疗方式。本研究的目的是评估 Roux-en-Y 胃旁路术（RYGB）在控制 BMI 为 30 至 35kg/m2 的 T2DM 患者中的疗效和安全性。
这是一项在巴西伯南布哥联邦大学进行的观察性、回顾性研究。在 2002 年至 2008 年间，有 27 名患者因未控制的 T2DM 接受了 RYGB 治疗，平均随访时间为 20 个月。评估了 T2DM 的完全缓解[糖化血红蛋白（HbA1c）<6%/空腹血糖（FPG）<100mg/dL/无糖尿病药物]和血糖控制情况。该大学的伦理委员会批准了该研究。
RYGB 带来了以下结果：（1）体重减轻 23%（p<0.001），BMI 在 12 个月内稳定在 25.6kg/m2；（2）血糖降低 46%，HbA1c 降低 27%（p<0.001）；（3）血糖改善 100%，T2DM 缓解 48%；（4）不服用药物的血糖控制率为 74%，服用药物的为 93%，5 名患者除了 RYGB 还需要服用药物；（5）目前的平均 FPG 为 93mg/dL，HbA1c 为 6%；（6）无严重并发症或死亡。
RYGB 是治疗伴有 I 类肥胖的未代偿 T2DM 的安全有效选择。
