Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity
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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.
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.
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.
OMBP is effective treatment for obesity in terms of weight loss and remission of T2D.
KeywordsBariatric surgery Gastric bypass Glycated haemoglobin Obesity Omega loop Type 2 diabetes
Drs. Guenzi, Arman, Rau, Cordun, Moszkowicz, Voron and Chevallier have no conflicts of interest or financial ties to disclose.
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