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Gastric Bypass Surgery Resolves Diabetes In Most Patients: Study

Posted: Friday, October 03, 2003

Washington - University of Pittsburgh School of Medicine study on obese people with Type 2 diabetes, who underwent laparoscopic gastric bypass surgery (LGBP), has revealed that 83 percent of them experienced a resolution of their disease.

According to the study published in the October issue of the Annals of Surgery, patients with the shortest duration and mildest form of Type 2 diabetes had a higher rate of resolution after surgery.

Type 2 diabetes is the most common form of diabetes. The body is unable to properly use the insulin that it produces. About 80 percent of people with the disease are overweight.

The LGBP procedure involves constructing a small stomach pouch of approximately 15 millimeters (about the size of a plastic medicine cup), and bypassing a small segment of intestines by constructing a Y-shaped limb of small bowel. Patients lose weight because there is a decrease in caloric intake resulting from the reduced reservoir capacity of the small stomach pouch.

Conclusions were reached after a survey of 1,160 patients who underwent Roux-en Y gastric bypass surgery (LGBP) between 1997 and 2002 at the University of Pittsburgh Medial Center. Of them, 240 had impaired fasting glucose and Type 2 diabetes. Follow-up was possible in 190. The mean age at surgery was 48 years and 75 percent of the patients were female. The mean body mass index was 50.

"Prior to surgery, the disease severity for these patients was quite significant overall," said Dr. Philip Schauer, director of bariatric surgery at the University of Pittsburgh and principal investigator in the study.

"With 65 percent of them requiring oral agents and 27 percent of them requiring insulin as well," he added.

Post surgery, patients had a mean excess weight loss of 60 percent and a body mass index of 34 after 20 months. Fasting plasma glucose and glycoslated hemoglobin concentrations returned to normal levels in 83 percent of patients, while 17 percent of patients markedly improved. Following surgery, 80 percent of patients had a significant reduction in the use of oral anti-diabetic agents and 79 percent had a reduction in their use of insulin.

"The impressive effect of bypass surgery on morbidly obese patients with type 2 diabetes raises an argument for lowering the threshold for surgical intervention to moderate or mild obesity," Dr. Schauer said. "Further investigation demonstrating risk versus benefit for patients with moderate obesity is warranted."

According to Schauer, the study suggests that early surgical intervention increases the likelihood of rendering these patients euglycemic.

"Younger diabetes patients with less severe disease stand to gain more from the surgery by circumventing years of progressive, debilitating disease," he added.

Source: Ani

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