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2 型糖尿病合并轻度肥胖患者的手术治疗初步结果。

Type 2 diabetes mellitus in patients with mild obesity: preliminary results of surgical treatment.

机构信息

Department of Surgery, Hospital J.J. Aguirre, University Hospital, Santos Dumont 999, Santiago, Chile.

出版信息

Obes Surg. 2013 Feb;23(2):234-40. doi: 10.1007/s11695-012-0780-3.

Abstract

In the last years, type 2 diabetes mellitus (T2DM) and obesity have become a serious public health problem, behaving as epidemic diseases. There is great interest in exploring different options for the treatment of T2DM in nonmorbidly obese patients. The purpose of this study is to report parameters of glycemic control in patients with T2DM and mild obesity who underwent laparoscopic Roux-en-Y gastric bypass (RYGBP). This prospective clinical trial includes patients with T2DM with a body mass index (BMI) between 30 and 35 kg/m(2) who underwent laparoscopic RYGBP from July 2008 through October 2010. Thirty-one patients were included in the study, 15 men and 16 women, with an average age of 48.7 ± 8.6 years. The average time since onset of T2DM was 5.8 years. The average postoperative follow-up was 30.4 months. The average preoperative blood glucose and glycosylated hemoglobin were 152 ± 70 mg/dl and 7.7 ± 2.1 %, respectively. All of them were using oral hypoglycemic agents, and four patients were insulin dependent. Only one patient had a postoperative complication (hemoperitoneum). At 36 months follow-up, the average BMI decreased to 24.7 kg/m(2), all patients (31) showed improvement in their glycemic control, and 29 of them (93.6 %) met the criteria for remission of T2DM in the last control. Laparoscopic RYGBP is a safe and effective procedure that improves glycemic control in patients with T2DM and mild obesity at midterm follow-up.

摘要

在过去的几年中,2 型糖尿病(T2DM)和肥胖症已成为严重的公共卫生问题,表现为流行疾病。人们对探索非病态肥胖患者 T2DM 的不同治疗选择非常感兴趣。本研究的目的是报告接受腹腔镜 Roux-en-Y 胃旁路术(RYGBP)的 T2DM 和轻度肥胖患者的血糖控制参数。这项前瞻性临床试验包括 2008 年 7 月至 2010 年 10 月期间接受腹腔镜 RYGBP 的 T2DM 患者,BMI 在 30 至 35kg/m2 之间。研究纳入了 31 名患者,其中男性 15 名,女性 16 名,平均年龄为 48.7±8.6 岁。T2DM 的平均发病时间为 5.8 年。平均术后随访时间为 30.4 个月。平均术前血糖和糖化血红蛋白分别为 152±70mg/dl 和 7.7±2.1%。他们都在服用口服降糖药,其中 4 名患者依赖胰岛素。只有 1 名患者发生术后并发症(血腹)。36 个月随访时,平均 BMI 降至 24.7kg/m2,所有患者(31 名)的血糖控制均得到改善,其中 29 名(93.6%)在最近一次控制时符合 T2DM 缓解标准。腹腔镜 RYGBP 是一种安全有效的手术,可在中期随访中改善 T2DM 和轻度肥胖患者的血糖控制。

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