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Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity

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Abstract

Background

Roux-en-Y gastric bypass (RYGBP) is a validated technique for the treatment of morbid obesity and results in a significant rate of remission of type 2 diabetes (T2D). Omega gastric bypass (OGBP) is an effective and simpler alternative for weight loss, but its effect on T2D is unclear.

Methods

Between December 2006 and September 2012, 804 laparoscopic OGBPs were carried out in our centre. Among these, 100 (12.4 %) patients had T2D at the time of the intervention. Remission of T2D was defined by a glycated haemoglobin (HbA1c) level of <6 % without concomitant treatment.

Results

Postoperative follow-up was completed by 81 patients (mean age: 49 ± 11 years; mean weight at surgery: 133 ± 29 kg; mean body mass index (BMI): 47 ± 9 kg/m2). Mean preoperative HbA1c was 8 ± 2 g/dL. Before OGBP, seven patients (9 %) had received no oral hypoglycaemic treatment, 30 (37 %) had received monotherapy, 26 (32 %) bitherapy, six (7 %) tritherapy and 12 (15 %) patients had used insulin. Over a mean follow-up of 26 months (range 1–75), mean weight decreased to 94 ± 23 kg and mean BMI to 35 kg/m2. Seventy-one (88 %) patients had complete remission of T2D and the other 10 (12 %) had reduced their treatment. Seven patients (58 %) initially treated with insulin no longer required this treatment. Mean time to remission of T2D for patients receiving one or more oral therapies versus insulin was 6.9 versus 17.9 months.

Conclusions

OMBP is effective treatment for obesity in terms of weight loss and remission of T2D.

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Disclosures

Drs. Guenzi, Arman, Rau, Cordun, Moszkowicz, Voron and Chevallier have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Digestive Surgery, Hôpital Européen Georges Pompidou, Paris, France

    Martino Guenzi, Gustavo Arman, Cédric Rau, Cristiana Cordun, David Moszkowicz, Thibault Voron & Jean-Marc Chevallier

  2. Assistance Publique-Hôpitaux de Paris, University Paris 5, Paris, France

    Martino Guenzi, Gustavo Arman, Cédric Rau, Cristiana Cordun, David Moszkowicz, Thibault Voron & Jean-Marc Chevallier

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  1. Martino Guenzi
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  2. Gustavo Arman
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Correspondence to Martino Guenzi.

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Guenzi, M., Arman, G., Rau, C. et al. Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity. Surg Endosc 29, 2669–2674 (2015). https://doi.org/10.1007/s00464-014-3987-7

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  • DOI: https://doi.org/10.1007/s00464-014-3987-7

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