J Korean Surg Soc.  2010 Jul;79(1):8-13. 10.4174/jkss.2010.79.1.8.

The Impact of Metabolic and Bariatric Surgery on Morbidly Obese Patients with Type 2 DM

• Lee H
• Kim M
• Kwon H
• Song K
• Kim E

• KMID: 1455481
• DOI: http://doi.org/10.4174/jkss.2010.79.1.8

Abstract

PURPOSE
Laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) are the most effective intervention and cure in achieving sustained weight loss in the morbidly obese with co-morbities, especially in type 2 diabetes mellitus (DM). Currently, there are few data in the literature presenting early diabetic outcomes between the 2 major bariatric surgeries in Korea. The aim of this study is to observe weight loss, improvement of type 2 DM after LRYGB and LAGB.
METHODS
33 retrospective data were obtained from diabetic subjects undergoing LRYGB (n=53) and LAGB (n=77). These measurements included age, sex, body mass index (BMI), pre-operative diabetic duration, post-operative diabetic at follow-up visit after surgery. Paired t-test, and SPSS12.0 were used for statistical analysis.
RESULTS
33 morbidly obese patients with type 2 DM who had both procedures complain of general weakness. Most patients were taking oral medications or insulin and tired of them. Pre and post-op 12 months of percent of excess weight loss (%EWL), fetal bovine serum (FBS), hemoglobin A1c (HbA1C) presented at 0%, 185.6 mg/dl, 8.7% and 70.6%, 123.4 mg/dl, 6.6% in patients who had LRYGB (P<0.05). Pre and post-op 12 months of %EWL, FBS, HbA1C presented at 0%, 180.6 mg/dl, 8.4% and 32.8%, 136.5 mg/dl, 6.8% in patients who had LAGB (P<0.05). Rate of discontinuance or decreasing for treatment of type 2 DM after surgery showed 94% for LRYGB versus 80% for LAGB, and unchanged rates were 6% versus 20%, respectively.
CONCLUSION
This study showed LRYGB and LAGB are quite satisfactory and promising bariatric procedures with significant weight loss and improvement of type 2 DM in Koreans. LRYGB is significantly associated with more weight loss, more diabetic outcome than LAGB. Clinical experiences in Korea with both procedures are limited and a larger number of cases are need, but the recent data shows promising results that are comparable to the international experience.

Keyword

Laparoscopic Roux-en-Y gastric bypass (LRYGB); Laparoscopic adjustable gastric banding (LAGB); Improvement of type 2 diabetes mellitus

MeSH Terms

Bariatric Surgery
Body Mass Index
Diabetes Mellitus, Type 2
Follow-Up Studies
Gastric Bypass
Hemoglobins
Humans
Insulin
Korea
Retrospective Studies
Weight Loss
Hemoglobins
Insulin

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