超越胰岛素：低体重指数胰岛素抵抗且不依从的2型糖尿病患者的改良袖状胃旁路术

Beyond Insulin: Modified OAGB in Low-BMI Insulin-Resistant and Non-compliant Type 2 Diabetic Patients.

作者信息

Kular Kiranjot Singh, Gill Shubhkaran Singh, Manchanda Naveen, Rutledge Robert, Kular Kuldeepak Singh

机构信息

Dayanand Medical College & Hospital, Ludhiana, India.

Kular College & Hospital Bija, Khanna, Punjab, India.

出版信息

Obes Surg. 2025 Mar;35(3):843-851. doi: 10.1007/s11695-025-07754-3. Epub 2025 Feb 25.

DOI:10.1007/s11695-025-07754-3

PMID:39998778

Abstract

BACKGROUND

Metabolic surgery's role in lower-BMI patients with type 2 diabetes mellitus (T2DM) remains debated, particularly regarding long-term outcomes.

METHODS

This retrospective study analyzed 54 patients (BMI 24-30 kg/m) with poorly controlled T2DM (HbA1c ≥ 10%) who underwent modified one anastomosis gastric bypass between 2016 and 2017. Primary outcomes included glycemic control, weight loss, and complications at 7 years.

RESULTS

Mean preoperative BMI was 26.76 ± 1.82 kg/m, and HbA1c was 12.63 ± 1.67%. Follow-up rates were year 1 (54/54, 100%), year 3 (52/54, 96.3%), year 5 (48/54, 88.9%), and year 7 (36/38, 94.7% of eligible patients). At 7-year follow-up, mean HbA1c decreased to 6.17 ± 0.71% (p < 0.001), and %TWL was 13.1 ± 2.4%. Complete medication elimination occurred in 45 of 54 patients (83.3%) achieving HbA1c < 6.5%. No mortality or major complications were reported.

CONCLUSIONS

Modified OAGB demonstrates sustained glycemic control and safety in lower-BMI patients with severe T2DM through 7 years with potential benefits of early surgical intervention.

摘要

背景

代谢手术在体重指数（BMI）较低的2型糖尿病（T2DM）患者中的作用仍存在争议，尤其是关于长期疗效。

方法

这项回顾性研究分析了2016年至2017年间接受改良单吻合口胃旁路手术的54例BMI为24 - 30kg/m²且T2DM控制不佳（糖化血红蛋白[HbA1c]≥10%）的患者。主要结局包括7年时的血糖控制、体重减轻和并发症。

结果

术前平均BMI为26.76±1.82kg/m²，HbA1c为12.63±1.67%。随访率分别为第1年（54/54，100%）、第3年（52/54，96.3%）、第5年（48/54，88.9%）和第7年（36/38，符合条件患者的94.7%）。在7年随访时，平均HbA1c降至6.17±0.71%（p<0.001），体重减轻百分比（%TWL）为13.1±2.4%。54例患者中有45例（83.3%）实现HbA1c<6.5%并完全停用药物。未报告死亡或重大并发症。