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十二指肠转位手术后肥胖和非肥胖患者2型糖尿病的改善情况。

Improvement of type 2 diabetes mellitus in obese and non-obese patients after the duodenal switch operation.

作者信息

Frenken M, Cho E Y, Karcz W K, Grueneberger J, Kuesters S

机构信息

Department of Surgery, St. Josef Hospital Monheim, 40789 Monheim am Rhein, Germany.

出版信息

J Obes. 2011;2011:860169. doi: 10.1155/2011/860169. Epub 2011 Mar 3.

DOI:10.1155/2011/860169
PMID:21461399
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3065014/
Abstract

Introduction. Type 2 diabetes mellitus (T2DM) is one of the most important obesity-related comorbidities. This study was undertaken to characterise the effect of the biliopancreatic diversion with duodenal switch (BPD-DS) in morbidly obese and nonmorbidly obese diabetic patients. Methods. Outcome of 74 obese diabetic patients after BPD-DS and 16 non-obese diabetic patients after BPD or gastric bypass surgery was evaluated. Insulin usage, HbA(1c)-levels, and index of HOMA-IR (homeostasis model assessment of insulin resistence) were measured. Results. A substantial fraction of patients is free of insulin and shows an improved insulin sensitivity early after the operation, another fraction gets free of insulin in a 12-month period after the operation and a small fraction of long-term insulin users will not get free of insulin but nevertheless shows an improved metabolic status (less insulin needed, normal HbA(1c)-levels). Conclusion. BPD-DS leads to an improvement of T2DM in obese and non-obese patients. Nevertheless, more data is needed to clarify indications and mechanisms of action and to adjust our operation techniques to the needs of non-obese diabetic patients.

摘要

引言。2型糖尿病（T2DM）是与肥胖相关的最重要的合并症之一。本研究旨在描述胆胰转流十二指肠转位术（BPD-DS）对病态肥胖和非病态肥胖糖尿病患者的影响。方法。评估了74例肥胖糖尿病患者接受BPD-DS术后以及16例非肥胖糖尿病患者接受BPD或胃旁路手术后的结果。测量了胰岛素使用情况、糖化血红蛋白（HbA1c）水平和胰岛素抵抗稳态模型评估（HOMA-IR）指数。结果。相当一部分患者术后早期无需使用胰岛素，且胰岛素敏感性得到改善；另一部分患者在术后12个月内无需使用胰岛素；一小部分长期使用胰岛素的患者虽仍需使用胰岛素，但代谢状态有所改善（所需胰岛素减少，糖化血红蛋白水平正常）。结论。BPD-DS可改善肥胖和非肥胖患者的T2DM。然而，需要更多数据来明确适应症和作用机制，并根据非肥胖糖尿病患者的需求调整我们的手术技术。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/5a0b74b9fe73/JOBES2011-860169.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/4eac20a0b68d/JOBES2011-860169.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/fd3342c2a238/JOBES2011-860169.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/be837a0374aa/JOBES2011-860169.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/24373a25709f/JOBES2011-860169.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/5a0b74b9fe73/JOBES2011-860169.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/4eac20a0b68d/JOBES2011-860169.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/fd3342c2a238/JOBES2011-860169.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/be837a0374aa/JOBES2011-860169.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/24373a25709f/JOBES2011-860169.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c8b2/3065014/5a0b74b9fe73/JOBES2011-860169.005.jpg

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Standards of medical care in diabetes--2010.《糖尿病医疗护理标准——2010》
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Standards of medical care in diabetes--2009.《糖尿病医疗护理标准——2009》
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