García-Caballero M, Valle M, Martínez-Moreno J M, Miralles F, Toval J A, Mata J M, Osorio D, Mínguez A
Departamento de Cirugía, Facultad de Medicina, Universidad de Málaga, Málaga, Spain.
Nutr Hosp. 2012 Mar-Apr;27(2):623-31. doi: 10.1590/S0212-16112012000200041.
Diabetes mellitus type 2 (DMT2) is a major cause of death in the world. The medical therapy for this disease has had enormous progress, but it still leaves many patients exposed to the complications developed from the disease. It is well known the beneficial effects of bariatric surgery in obese diabetic patients, however it is important to investigate if the same principles of bariatric surgery that improve diabetes in obese patients, could be applied to non obese normal weight diabetics.
Thirteen diabetic patients operated by One Anastomosis Gastric Bypass (BAGUA), were evaluated in the preoperative period and 1,3 and 6 months after surgery. Body weight and composition, Fasting Plasma Glucose, HbA1c levels, blood pressure and serum lipids levels were analyzed, as well as the monitoring of the immediate postoperative treatment necessities for Diabetes and other metabolic syndrome comorbidities.
After the surgery the 77% of the patients resolves its T2DM, 46% from surgery, and rest noted an significant improvement of the disease in spite of having a C peptide level near to zero some of the patients. The comorbidities, mainly hypertension and lipid abnormalities experience improvement early. All patients reduce their weight and the amount of fat mass until values consistent with their age and height.
The One Anastomosis Gastric Bypass leads to resolution or improvement of T2DM in non obese normal weight patients. The best results are obtained in patients with few years of diabetes, without or short term use of insulin treatment and high C-peptide levels.
2型糖尿病(DMT2)是全球主要的死亡原因之一。针对这种疾病的药物治疗已经取得了巨大进展,但仍有许多患者面临该疾病引发的并发症。众所周知,减重手术对肥胖糖尿病患者有益,然而,研究减重手术改善肥胖患者糖尿病的相同原理是否可应用于非肥胖的正常体重糖尿病患者非常重要。
对13例行单吻合口胃旁路手术(BAGUA)的糖尿病患者在术前、术后1个月、3个月和6个月进行评估。分析体重和身体成分、空腹血糖、糖化血红蛋白水平、血压和血脂水平,以及监测糖尿病和其他代谢综合征合并症术后即刻的治疗需求。
术后77%的患者2型糖尿病得到缓解,46%在术后即刻缓解,其余患者尽管部分患者C肽水平接近零,但疾病仍有显著改善。合并症,主要是高血压和血脂异常,早期得到改善。所有患者体重减轻,脂肪量减少至与其年龄和身高相符的值。
单吻合口胃旁路手术可使非肥胖正常体重患者的2型糖尿病得到缓解或改善。糖尿病病程较短、未使用或短期使用胰岛素治疗且C肽水平较高的患者效果最佳。