Laparoscopic Roux-en-Y gastric bypass for type 2 diabetes mellitus in nonobese Chinese patients

Surg Laparosc Endosc Percutan Tech. 2014 Dec;24(6):e200-6. doi: 10.1097/SLE.0000000000000068.

Abstract

Background: Although bariatric surgery performed for morbid obesity has been shown to significantly improve type 2 diabetes mellitus (T2DM), data on its effectiveness to improve T2DM in nonobese patients are scarce. The present pilot study evaluated the clinical effects of laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in Chinese T2DM patients with body mass index (BMI) ≤27.5 kg/m.

Materials and methods: A total of 68 consecutive patients with uncontrolled T2DM underwent LRYGB from May 2010 to March 2012. All patients were subjected to follow-up controls with anthropometric and metabolic indices at 1, 3, 6, and 12 months after surgery. Glycemic control was evaluated.

Results: One year after the surgery, LRYGB resulted in 69.4%±52.2% excess weight loss percentage (%EWL), remission of T2DM in 80.9% of all the patients. In the group of T2DM patients with BMI≤27.5 kg/m (n=28), 9 (32.1%) cases showed T2DM remission, 10 (35.7%) showed glycemic control, 7 (25%) showed improvement, and 2 (7.1%) were unchanged. The change in BMI, waist circumference, and the plasma levels of FPG, HbA1C, triglycerides, HDL-C, and insulin were statistically significance at 1 year (P<0. 05). There was no perioperative mortality, but 6 (8.8%) patients experienced complications.

Conclusions: LRYGB resulted in significant weight loss and remission of T2DM in Chinese patients. Despite a lower response rate of surgery treatment compared with obese patients, T2DM patients with BMI≤27.5 kg/m still exhibited improvement and remission of T2DM. Diabetic patients should consider bariatric surgery, especially if traditional pharmacotherapy has not been effective. Longer follow-up is required for better evaluation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Mass Index
  • C-Peptide / metabolism
  • China / ethnology
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / ethnology
  • Diabetes Mellitus, Type 2 / surgery*
  • Gastric Bypass / methods*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Laparoscopy / methods*
  • Lipid Metabolism / physiology
  • Middle Aged
  • Perioperative Care / methods
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult

Substances

  • C-Peptide
  • Glycated Hemoglobin A