The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2
To aim of the study was to investigate the effect of bilio-pancreatic diversion (BPD) on type 2 diabetes in patients with BMI <35 kg/m2.
OGTTs were performed and anthropometric data were compared between five diabetes patients (BMI 27–33 kg/m2) following BPD and seven diabetes patients after a low-energy diet. Insulin secretion was computed by C-peptide deconvolution. A euglycaemic–hyperinsulinaemic clamp was performed only in the BPD group and the M value measured.
One month after BPD, fasting and 2 h post-OGTT glycaemia decreased from 15.22 ± 3.22 to 6.22 ± 0.51 mmol/l (p = 0.043), while insulin sensitivity increased significantly. No significant changes were observed in the low-energy diet group. Insulin secretion did not differ significantly after either intervention. Diabetes amelioration (change in HbA1c level) was observed up to 18 months after BPD without pharmacological therapy.
BPD can achieve adequate control of type 2 diabetes also in patients with BMI <35 kg/m2. The rapid postoperative remission of diabetes is primarily related to an improvement in insulin sensitivity.
- Buchwald, H, Avidor, Y, Braunwald, E (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292: pp. 1724-1737 CrossRef
- Rubino, F, Forgione, A, Cummings, D (2006) The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg 244: pp. 741-749 CrossRef
- Lee, WJ, Wang, W, Lee, YC, Huang, MT, Ser, KH, Chen, JC (2008) Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI >35 and <35 kg/m2. J Gastrointest Surg 12: pp. 945-952 CrossRef
- Cohen, RV, Schiavon, CA, Pinheiro, JS, Correa, JL, Rubino, F (2007) Duodenal–jejunal bypass for the treatment of type 2 diabetes in patients with body mass index of 22–34 kg/m2: a report of 2 cases. Surg Obes Relat Dis 3: pp. 195-197 CrossRef
- Dixon, JB, O’Brien, PE, Playfair, J (2008) Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 299: pp. 316-323 CrossRef
- Genuth, S, Alberti, KG, Bennett, P (2003) Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26: pp. 3160-3167 CrossRef
- Scopinaro, N, Gianetta, E, Civalleri, D, Bonalumi, U, Bachi, V (1979) Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg 66: pp. 618-620 CrossRef
- Guidone, C, Manco, M, Valera-Mora, E (2006) Mechanisms of recovery from type 2 diabetes after malabsorptive bariatric surgery. Diabetes 55: pp. 2025-2031 CrossRef
- Cauter, E, Mestrez, F, Sturis, J, Polonsky, KS (1992) Estimation of insulin secretion rates from C-peptide levels: comparison of individual and standard kinetic parameters for C-peptide clearance. Diabetes 41: pp. 368-377 CrossRef
- Mari, A, Pacini, G, Murphy, E, Ludvik, B, Nolan, JJ (2001) A model-based method for assessing insulin sensitivity from the oral glucose tolerance test. Diabetes Care 24: pp. 539-548 CrossRef
- The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2
Volume 52, Issue 6 , pp 1027-1030
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Bilio-pancreatic diversion
- BMI <35 kg/m2
- Hypocaloric diet
- Insulin secretion
- Insulin sensitivity
- Type 2 diabetes
- Industry Sectors
- Author Affiliations
- 1. Department of Internal Medicine, Catholic University, Largo A. Gemelli, 8, 00168, Rome, Italy
- 2. Weill Cornell Medical College/New York Presbyterian Hospital, New York, USA
- 3. Department of Surgery, Catholic University, Rome, Italy