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Surg Endosc. 2018 Mar;32(3):1353-1359. doi: 10.1007/s00464-017-5815-3. Epub 2017 Aug 15.

Type 2 diabetes mellitus outcomes after laparoscopic gastric bypass in patients with BMI <35 kg/m2 using strict remission criteria: early outcomes of a prospective study among Mexicans.

Author information

1
The Obesity Clinic at Hospital General Tláhuac, Avenida La Turba 655, Colonia Villa Centro Americana y del Caribe, Delegación Tláhuac, 13250, Mexico City, Mexico.
2
The Obesity Clinic at Hospital General Tláhuac, Avenida La Turba 655, Colonia Villa Centro Americana y del Caribe, Delegación Tláhuac, 13250, Mexico City, Mexico. zerrweck@yahoo.com.

Abstract

BACKGROUND:

Mild obesity (BMI 30-34.9 kg/m2) is highly prevalent worldwide and is associated with type 2 diabetes mellitus. The efficacy of bariatric surgery remains unclear, including among Mexicans. The criteria for diabetes remission are inconsistent, as they are based on different thresholds for glycated hemoglobin, with remission rates ranging from 43 to 73%.

METHODS:

Mildly obese patients with type 2 diabetes mellitus who underwent laparoscopic gastric bypass were prospectively analyzed. The primary objective was to determine the impact of surgery on their metabolic profiles. Demographic, clinical, and biochemical parameters were measured at baseline and at 3, 6, 9, 12, and 18 months. Diabetes remission rate was defined as an HbA1c <5.7%. Complications within 30 days and weight loss (% total weight loss) were also analyzed.

RESULTS:

Twenty-three Mexican patients underwent surgery. Of the 19 patients, evaluable at 18 months, nine (47.4%) achieved complete diabetes remission, seven (36.8%) showed partial remission, and three (15.8%) showed improvement. Significant improvements in lipid profile, cardiovascular risk, blood pressure, and every metabolic parameter were observed, beginning at the first month and throughout the study. The final total percentage weight loss was 24.9%. Three patients (13%) experienced complications, but none required reoperation or died.

CONCLUSION:

Laparoscopic gastric bypass is a safe and effective method to improve the metabolic profile of mildly obese Mexican patients with type 2 diabetes mellitus, inducing high remission rates even when the strictest model is used.

KEYWORDS:

Bariatric surgery; Diabetes remission; Diabetes surgery; Laparoscopic gastric bypass; Latinos; Metabolic surgery; Mexicans; Mild obesity; Obesity grade 1; Surgery

PMID:
28812155
DOI:
10.1007/s00464-017-5815-3
[Indexed for MEDLINE]

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