Comparison of rates of resolution of diabetes mellitus after gastric banding, gastric bypass, and biliopancreatic diversion
| Autor: | H. Leon Pachter, Manish Parikh, Christine J. Ren, George Fielding, Eleny Romanos, Nichole Lewis, Patricia Ayoung-Chee |
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| Rok vydání: | 2007 |
| Předmět: |
Male
medicine.medical_specialty Gastroplasty medicine.medical_treatment Gastric bypass Gastric Bypass Gastroenterology Internal medicine Diabetes mellitus medicine Diabetes Mellitus Humans Biliopancreatic Diversion biology business.industry Stomach Insulin Remission Induction nutritional and metabolic diseases Middle Aged medicine.disease biology.organism_classification Duodenal switch Surgery medicine.anatomical_structure Tasa Female business Body mass index |
| Zdroj: | Journal of the American College of Surgeons. 205(5) |
| ISSN: | 1879-1190 |
| Popis: | Bariatric operation is the most effective treatment for diabetes mellitus in the morbidly obese. The purpose of this study is to compare the rate of resolution of diabetes mellitus after three common laparoscopic bariatric procedures: laparoscopic adjustable gastric banding (LAGB), Roux-en-Y gastric bypass (RYGB), and biliopancreatic diversion with or without duodenal switch (BPD/DS).All data were prospectively collected and entered into an electronic registry. Characteristics evaluated for this study included preoperative age, body mass index, duration of diabetes, race, gender, operative time, length of stay, percent excess weight loss, oral hypoglycemic requirements, and insulin requirements.A total of 282 bariatric patients with diabetes mellitus were analyzed (218 LAGB, 53 RYGB, and 11 BPD/DS). Preoperative age (46 to 50 years), body mass index (46 to 50; calculated as kg/m(2)), race and gender breakdown, and baseline oral hypoglycemic (82% to 87%) and insulin requirements (18% to 28%) were comparable among the three groups (p = NS). Percent excess weight loss at 1, 2, and 3 years was: 43%, 50%, and 45% for LAGB; 66%, 68%, and 66% for RYGB; and 68%, 77%, and 82% for BPD/DS (p0.01 LAGB versus RYGB and LAGB versus BPD/DS at all time intervals). At 1 and 2 years, the proportion of patients requiring oral hypoglycemics postoperatively was 39% and 34% for LAGB; 22% and 13% for RYGB; and 11% and 13% for BPD/DS (p = NS). At 1 and 2 years, the proportion of patients requiring insulin postoperatively was 14% and 18% for LAGB; 7% and 13% for RYGB; and 11% and 13% for BPD/DS (p = NS).Despite the disparity in percent excess weight loss between LAGB, RYGB, and BPD/DS, the rate of resolution of diabetes mellitus is equivalent. |
| Databáze: | OpenAIRE |
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