Effectiveness of laparoscopic Roux-en-Y gastric bypass on obese class I type 2 diabetes mellitus patients

• Published in: Surgery for obesity and related diseases Vol. 11; no. 6; pp. 1220 - 1226
• Main Authors: Xu, Lu, M.D, Yin, Jun, M.D, Mikami, Dean J., M.D, Portenier, Dana D., M.D, Zhou, Xiaojun, M.D, Mao, Zhongqi, M.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.11.2015
• Subjects: Blood Glucose - metabolism; Body Mass Index; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - therapy; Female; Follow-Up Studies; Gastric Bypass - methods; Gastroenterology and Hepatology; Humans; Laparoscopy; LRYGB; Male; Middle Aged; Obese class I patients; Obesity, Morbid - complications; Obesity, Morbid - surgery; Prospective Studies; Remission Induction - methods; Surgery; Time Factors; Treatment Outcome; Type 2 diabetes mellitus; Obese class I patients; LRYGB; Type 2 diabetes mellitus
• ISSN: 1550-7289; 1878-7533
• DOI: 10.1016/j.soard.2015.02.013

Abstract Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) can dramatically improve type 2 diabetes mellitus (T2D) in obese class II and III patients. There is increasing evidence that shows bariatric surgery can also ameliorate T2D in patients with BMI between 30 kg/m2 and 35 kg/m2 (obese class I). Objective To compare the effectiveness of LRYGB on T2D in obese class I patients with that of obese class II and III T2D patients. Setting University Hospital, China Methods A prospective study was performed in the authors’ center from March 2010 to July 2011. Forty-two consecutive obese patients were included in the study. Anthropometric and metabolism parameters were compared between obese class II and III patients and obese class I patients before and after LRYGB. Results No patients were lost to follow up. After 36 months, metabolic parameters significantly improved in both groups. Partial remission rates between the 2 groups at each time point (12 months, 24 months, and 36 months) were comparable. Obese class II and III patients had higher complete remission rates at 12 months and 24 months, but no difference was observed at 36 months. Conclusion Both obese class II and III patients and obese class I T2D patients showed significant improvement in multiple parameters after LRYGB. Obese class II and III patients had a higher complete remission rate than obese class I patients. Standardized remission criteria are needed to make outcomes form different centers comparable. Large prospective studies are needed and long-term outcomes have to be observed to better evaluate effectiveness of LRYGB on obese class I T2D patients.