Authors: Enrique Lanzarini Attila Csendes Hans Lembach Juan Molina Luis Gutiérrez Johanna Silva
Publish Date: 2010/06/08
Volume: 34, Issue: 9, Pages: 2098-2102
Abstract
Bariatric surgery in morbidly obese patients with type 2 diabetes results systematically in adequate glycemic control normalization of insulinemia and a decrease in glycosylated hemoglobin effects that appear early after surgery in nearly 80 to 90 of them Possible reasons that have been discussed are a decrease in caloric consumption weight loss and hormonal changes at the gastrointestinal level which could have a positive effect on glucose metabolism Various authors have proposed the possibility of passing on this indication to diabetic patients who are overweight or are mildly obese The purpose of this retrospective investigation was to determine the effect of total or subtotal gastrectomy with RouxenY reconstruction on the metabolic control of patients with type 2 diabetes with a body mass index BMI 35 operated on for reasons other than obesityFrom January 1999 to December 2007 a total of 23 diabetic patients who underwent total or subtotal gastrectomy with a gastrojejunal or esphagojejunal anastomosis with RouxenY reconstruction of 60 to 70 cm length were included in this investigationThe group consisted of 23 patients 14 men 9 women average age 629 ± 79 years average BMI 291 ± 51 The principal reason for gastrectomy in these patients was gastric cancer in 19 patients 826 The surgical procedure was total gastrectomy in 17 cases 739 and subtotal gastrectomy in 6 cases 261 Postoperative followup was 22 months Before surgery the mean blood glucose level was 1514 mg/dl Late after surgery 15 patients 652 had a fasting blood glucose 126 mg/dl and are not using medication remission 7 304 patients have better metabolic control with a normal blood glucose but are still taking medication improvement and just 1 43 patient has an altered blood glucose and uses insulin no change
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