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Seven Years of Mini-Gastric Bypass in Type II Diabetes Patients with a Body Mass Index <35 kg/m2

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Abstract

Background

Mini-gastric bypass (MGB) is a safe, effective, and reversible procedure for patients with type II diabetes mellitus (T2DM) and morbid obesity. Less is known, however, about its long-term effects in patients with a body mass index (BMI) <35 kg/m2.

Methods

From February 2007 to February 2014, 1468 patients underwent MGB at our institution, including 983 with T2DM. Of these, 128 (82 women), of mean age 41.6 ± 10.2 years, had a BMI of 30–35 kg/m2. Prospectively collected data were analyzed retrospectively. Factors assessed included disease duration, family history, medication use, remission, and biochemical indicators, including fasting plasma glucose, glycosylated hemoglobin (HbA1c), serum insulin, and C-peptide concentrations. Remission of T2DM was defined as HbA1c <6.0 % without medication.

Results

Prior to surgery, patients had a mean BMI of 33.4 ± 3.3 kg/m2, mean waist circumference of 104.5 ± 8.2 cm, mean C-peptide concentration of 3.4 ± 1.2 ng/ml, and mean T2DM duration of 6.5 ± 3.1 years. Within 6 months of MGB, 95 % of these patients had attained HbA1c <7 %. Complete remission rates at 1, 2, and 7 years were 64, 66, and 53 %, respectively. Mean HbA1c decreased from 10.7 ± 1.5 % at baseline to 6.2 ± 0.5% at 1 year, 5.4 ± 1.2 % at 3 years, and 5.7 ± 1.8 % at 7 years. No deaths occurred, but two (1.6 %) patients experienced major complications.

Conclusions

MGB provides good, long-term control of T2DM in patients with class I obesity. Early intervention results in higher remission rates.

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Authors and Affiliations

  1. Kular Medical Education and Research Society, Kular Group of Institutes, NH 1, Bija, Khanna, Ludhiana, Punjab, 141412, India

    Kuldeepak S. Kular

  2. Bariatric Surgery, Kular Hospital, NH 1, Bija, Khanna, Ludhiana, Punjab, India

    Naveen Manchanda

  3. Kular Group of Institutes, NH 1, Bija, Khanna, Ludhiana, Punjab, 141412, India

    Gurpreet K. Cheema

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  1. Kuldeepak S. Kular
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Correspondence to Kuldeepak S. Kular.

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Conflict of Interest

The authors declare that they have no competing interests.

Ethical Approval

All procedures performed in our study involving human participants were in accordance with the ethical standards of the institutional committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Our study is retrospective, and for this type of study, a formal consent/approval is not required.

Informed Consent

Informed consent for procedure was obtained from all individual participants.

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Kular, K.S., Manchanda, N. & Cheema, G.K. Seven Years of Mini-Gastric Bypass in Type II Diabetes Patients with a Body Mass Index <35 kg/m2 . OBES SURG 26, 1457–1462 (2016). https://doi.org/10.1007/s11695-015-1941-y

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