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>Journals >Cirujano General >Year 2017, Issue 2


Menchaca RLG, Larios FMC, Garza MRA
Gastric bypass as a metabolic management model in type 2 diabetes mellitus and obesity grade 1, compared to conventional treatment
Cir Gen 2017; 39 (2)

Language: Español
References: 35
Page: 74-81
PDF: 4. Kb.


Full text




ABSTRACT

Background: Type 2 diabetes (DM2) is a public health problem worldwide. In 1994 Pories reported glycemic correction after gastric bypass in obese patients with DM2; then, Rubino, Scopinaro (2002) and Carbajo (2008) confirmed this glycemic normalization during the first postoperative week. Studies in patients submitted to gastrojejunal surgery due to peptic acid disease or neoplasms reported similar results in blood glucose control. The American Diabetes Association justifies this procedure to be performed under protocol study in patients with BMI between 30 and 35. Material and methods: A non-blind experimental cohort study; 47 patients with type 2 diabetes and grade I obesity were selected at the High Specialty Regional Monterrey Hospital, ISSSTE; 13 patients (cases) underwent gastric bypass and were compared versus 34 patients in conventional clinical treatment (control) in one-year follow-up. Results: The 13 patients who underwent surgery (eight female and five male) started with a mean HbA1c = 9.7%, which decreased to 6% post-surgery. Only three of them continue with oral hypoglycemic agents in minimal doses. Regarding the 34 clinical treatment patients, their initial (2015) mean HbA1c = 9.2%, and their 2016 mean = 8.9%, maintaining medications. Discussion: The control group had a high risk of complications. Gastric bypass showed to be more effective in the control of HbA1c. Conclusions: Patients with DM2 and BMI between 30 and 35 are a highly vulnerable group, which should be included in bariatric surgical procedures to avoid complications with irreparable damage.


Key words: Gastric bypass, metabolic surgery, obesity, diabetes.


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