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Predictors for Remission of Major Components of the Metabolic Syndrome After Biliopancreatic Diversion with Duodenal Switch (BPDDS)

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Abstract

Background

Metabolic surgery causes the remission of type 2 diabetes mellitus (T2DM), hypertension, and hyperlipidemia to varying degrees, depending on the patient characteristics and the surgical procedure. The aim of this study was to find predictors for the remission of T2DM and hypertension after biliopancreatic diversion with duodenal switch (BPDDS).

Methods

Eighty patients with T2DM were followed up for 2 years or more after BPDDS, and changes in body weight and metabolic status were noted. Remission was defined as fasting glucose <7 mmol/l with HbA1C <6.5 %, blood pressure <140/90 mmHg, and low-density lipoprotein (LDL) <2.6 mmol without the use of medication.

Results

Preoperatively, the mean age was 44 years, body mass index (BMI) was 48 kg/m2, and duration of diabetes was 5 years. Of the 80 patients, 38 patients were using insulin, 48 patients were using antihypertensives, and 38 patients were using a lipid-lowering drug. Five percent of the patients had recommended levels for HbA1C, blood pressure, and LDL prior to the operation. The remission rate at 2 years was 94 % for T2DM, 54 % for hypertension, and 86 % for LDL hyperlipidemia. Preoperative predictors for nonremission of T2DM were a higher BMI, insulin usage, and low insulin C-peptide, and for hypertension, older age and more severe hypertension. Postoperative weight loss was important for both.

Conclusions

Surgical intervention with BPDDS is an effective treatment of T2DM, hypertension, and hyperlipidemia. The duration of T2DM and age of the patient are the most important preoperative predictors for the remission of T2DM and hypertension, respectively.

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Conflict of Interest

The first author had travel expenses for one international conference in 2010 covered by Covidien Norway through an educational grant given to the Surgical Department, Unit for Bariatric Surgery, Førde Central Hospital. Roy M. Nilsen, Arnold Berstad, Jan Behme, Nils Sletteskog, Ronny Gåsdal, Camilla Laukeland, and Gunnar Mellgren do not have any commercial associations that might be a conflict of interest in relation to this article.

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Authors and Affiliations

  1. Department of Surgery, Førde Central Hospital, 6807, Førde, Norway

    Villy Våge, Jan Behme, Nils Sletteskog, Ronny Gåsdal & Camilla Laukeland

  2. Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway

    Roy M. Nilsen

  3. Unger Vetlesen’s Institute, Lovisenberg Diakonale Hospital, Oslo, Norway

    Arnold Berstad

  4. Hormone Laboratory, Haukeland University Hospital, Bergen, Norway

    Gunnar Mellgren

  5. Institute of Medicine, University of Bergen, Bergen, Norway

    Gunnar Mellgren

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  1. Villy Våge
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  2. Roy M. Nilsen
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  3. Arnold Berstad
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Correspondence to Villy Våge.

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Våge, V., Nilsen, R.M., Berstad, A. et al. Predictors for Remission of Major Components of the Metabolic Syndrome After Biliopancreatic Diversion with Duodenal Switch (BPDDS). OBES SURG 23, 80–86 (2013). https://doi.org/10.1007/s11695-012-0775-0

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  • DOI: https://doi.org/10.1007/s11695-012-0775-0

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