, Volume 52, Issue 6, pp 1027-1030
Date: 24 Mar 2009

The effect of bilio-pancreatic diversion on type 2 diabetes in patients with BMI <35 kg/m2

Abstract

Aims/hypothesis

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.

Methods

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.

Results

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.

Conclusions/interpretation

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.