Obesity Surgery

, Volume 21, Issue 7, pp 880–888 | Cite as

The Effects of Biliopancreatic Diversion on Type 2 Diabetes Mellitus in Patients with Mild Obesity (BMI 30–35 kg/m2) and Simple Overweight (BMI 25–30 kg/m2): A Prospective Controlled Study

  • Nicola ScopinaroEmail author
  • Giovanni F. Adami
  • Francesco S. Papadia
  • Giovanni Camerini
  • Flavia Carlini
  • Lucia Briatore
  • Gabriele D’Alessandro
  • Corrado Parodi
  • Andrea Weiss
  • Gabriella Andraghetti
  • Mariafrancesca Catalano
  • Renzo Cordera
Clinical Research



Beneficial effects of BPD on T2DM in BMI >35 kg/m2 patients are far better than those in patients with BMI 25–35. This study was aimed at investigating if a similar difference exists between patients with mild obesity (OB, BMI 30–35) or simple overweight (OW, BMI 25–30).


Fifteen OB (six M) and 15 OW (13 M), diabetic for ≥3 years, with HbA1c ≥7.5% despite medical therapy, underwent BPD. OB/OW: age 55.1 ± 8.0/57.8 ± 6.7 years, BMI 33.1 ± 1.5/28.0 ± 1.3 kg/m2, diabetes duration 11.6 ± 8.0/11.1 ± 6.1 years, insulin therapy 4/8 p. FSG and HbA1c were determined preoperatively and up to 2 years. Insulin resistance and beta-cell function were explored by means of HOMA-IR and IVGTT (AIR). Thirty-eight diabetic patients on medical therapy served as controls.


Mean BMI stabilized around 27 since the 4th month in OB, and 24 since 1st month in OW. FSG in OB/OW preop, 1, 12, 24 months: 234 ± 76/206 ± 62 mg/dL, 154 ± 49/176 ± 75, 131 ± 32/167 ± 48, 134 ± 41/154 ± 41 (cross-sectional n.s. at all times); HbA1c: 9.5 ± 1.6/9.1 ± 1.3, 7.3 ± 1.1/7.3 ± 1.2, 5.9 ± 0.6/7.1 ± 1.1 (p < 0.01), 5.9 ± 0.9/6.9 ± 1.1 (p < 0.01). HOMA-IR, preoperatively 10.7 ± 5.8/7.5 ± 5.4, went below 3.0 at 1 month and remained such until 2 years in both groups. AIR, preoperatively 1.11 ± 3.17/1.27 ± 2.68 μIU/mL, in OB significantly increased at 4 months to 7.63 ± 5.79, maintained up to 2 years with 6.95 ± 3.19, whereas in OW, statistical significance was reached only at 2 years with 5.02 ± 4.87.


Significantly different BPD effect, thus biological severity of T2DM, also exists between mildly obese and simply overweight patients. The rise of AIR allows hoping that an increase of beta-cell mass may occur in the long run. Identifier: NCT00996294


Type 2 diabetes Surgery Biliopancreatic diversion Diabetes surgery Metabolic surgery Insulin resistance Beta-cell function Islet function 


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Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Nicola Scopinaro
    • 1
    • 3
    Email author
  • Giovanni F. Adami
    • 1
  • Francesco S. Papadia
    • 1
  • Giovanni Camerini
    • 1
  • Flavia Carlini
    • 1
  • Lucia Briatore
    • 2
  • Gabriele D’Alessandro
    • 1
  • Corrado Parodi
    • 1
  • Andrea Weiss
    • 1
  • Gabriella Andraghetti
    • 2
  • Mariafrancesca Catalano
    • 1
  • Renzo Cordera
    • 2
  1. 1.Department of SurgeryUniversity of Genoa Medical SchoolGenoaItaly
  2. 2.Department of EndocrinologyUniversity of Genoa Medical SchoolGenoaItaly
  3. 3.DISCUniversità di GenovaGenoaItaly

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