Effects of biliopanceratic diversion on type 2 diabetes in patients with BMI 25 to 35.

摘要

OBJECTIVE: Biliopancreatic diversion (BPD) resolves type 2 diabetes in near totality of morbidly obeses [BMI (body mass index) >/=35 kg/m]. However, studies of BPD effect in BMI range 25.0 to 34.9 kg/m, including about 90% of diabetic patients, are lacking. MATERIALS AND METHODS: If BPD effects are independent of weight changes, they should be maintained in patients who, being mildly obese or overweight, will lose little or no weight after operation. Thirty type 2 diabetic patients with BMI 25 to 34.9 were submitted to BPD and monitored 12 months. Thirty-eight diabetic patients selected from a large database, kept 1 year on medical therapy, served as controls. RESULTS: Nineteen male and 11 female. Mean age 56.4 +/- 7.4 years, weight 84.8 +/- 11.1 kg, BMI 30.6 +/- 2.9 kg/m, waist circumference 104 +/- 9.4 cm, diabetes duration 11.2 +/- 6.9 years, HbA1c 9.3+/-1.5. Twelve patients on insulin. Fifteen (2 F) with BMI < 30 (mean: 28.1). No mortality or major adverse events occurred. BMI progressively decreased, stabilizing around 25 since the fourth month, without excessive weight loss. One year after BPD, mean HbA1c was 6.3%+/-0.8, with 25 patients (83%) controlled (HbA1c