Evaluation of weight loss and metabolic profile of obese patients with type 2 diabetes mellitus (dm2) versus non-dm2 subjects, one and three years after bariatric surgery

ABCD. Arquivos Brasileiros de Cirurgia Digestiva (São Paulo)

Thiago Fraga Napoli²  Mariana Furieri Guzzo²  Douglas Kawashima Hisano²  Paulo Gustavo Figueiredo Salgado Ribeiro²  Vanessa Junqueira Guedes²  Joyce Chermikosky Ozawa²  Camila Campos Padovese¹  Carlos Alberto Malheiros¹  Murilo Rezende Melo¹  Nilza Maria Scalissi²  Osmar Monte²  João Eduardo Salles² 

[1] ,Santa Casa de Misericórdia de São Paulo Department of Internal Medicine Unit of the Irmandade

关键词: Diabetes Mellitus;    Bariatric surgery;    Hemoglobin A;    Glycosylated;    Weight loss;    Lipids;    Diabetes Mellitus;    Cirurgia Bariátrica;    Hemoglobina A glicosilada;    Perda de peso;    Lipídeos;   

DOI  :  10.1590/S0102-67202010000200008

来源: SciELO

【 摘 要 】

BACKGROUND: There is a debate over results obtained from type 2 diabetes mellitus (DM2) obese patients and non-DM2 patients, in reference to metabolic control and ponderal loss, after bariatric surgery. AIM: To evaluate weight loss and metabolic profile of obese patients with DM2 versus non-DM2 subjects, one and three years after bariatric surgery. METHODS: Data from 38 non-DM2 patients and 44 DM2 patients submitted to Roux-en-Y gastric-bypass were analysed retrospectively. For the pre-operatory, first and third year of post-operatory, were compared: weight, body mass index (BMI), fasting glucose (FG), high density lipoprotein (HDL) and triglycerides (TG). RESULTS: Preoperatively, both groups were statistically equivalent in regards to weight, BMI (P = 0.90) and HDL (P = 0.73). This was not the case when TG (P = 0.043) and FG (P<0.01) were analyzed. In PO1, both DM2 and non-DM2 groups showed a reduction in weight, BMI and TG, just as FG in the DM2 group (P < 0.05). HDL increased (P < 0.05) in PO1 in both groups. In the following period, between PO1 and PO3, only TG continued to decrease in the non-DM2 group (P = 0.039), while the other variables did not change. In the DM2 group mean A1c in PO3 was 6.2% +- 0.75 (P = 0.027). It was compared both group's post-operative data. HDL's and TG's variation between groups did not differ in PO1 or between PO1 and PO3. Weight in PO1 and PO3, just as BMI in PO1 and PO3, were not significantly different either. CONCLUSION: In PO1, weight loss and metabolic improvement was seen in both groups. This was sustained in PO3, with no significant weight regain or lipid/FG change. A1c found suggests a reasonable control of DM2 surgery. A trend towards a less intense weight loss could be noticed in the DM2 group (P = 0.053).

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