Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures?
Diabetes mellitus (DM) is a public health problem with a prevalence of 345 million people worldwide that it may double by the year 2030 and have a high costs and mortality. Gastrointestinal surgery is accepted as a form of treatment that was already suggested for obese in 1987 by Pories, confirmed f...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Arán Ediciones, S. L.
|
| Series: | Nutrición Hospitalaria |
| Subjects: | |
| Online Access: | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112013000800005&lng=en&tlng=en |
| _version_ | 1818851971230072832 |
|---|---|
| author | M. Garciacaballero S. Navarrete F . Favretti A. Celik D. Del Castillo |
| author_facet | M. Garciacaballero S. Navarrete F . Favretti A. Celik D. Del Castillo |
| author_sort | M. Garciacaballero |
| collection | DOAJ |
| description | Diabetes mellitus (DM) is a public health problem with a prevalence of 345 million people worldwide that it may double by the year 2030 and have a high costs and mortality. Gastrointestinal surgery is accepted as a form of treatment that was already suggested for obese in 1987 by Pories, confirmed for obese patients by the meta-analysis of Buchwald and the direct comparison of gastric bypass with medical treatment in the study of Schauer that demonstrate a 4 fold greater resolution rate of DM with surgery. Improvement occurs immediately after surgery, before the patients lose weight in with BMI > 35; but there is doubt if the existent evidence is enough to extrapolate these results to patients with BMI < 35 and especially with BMI < 30, in spite that four reviews in patients with this BMI and DM2 demonstrated the same results when stomach, duodenum and part of jejunum is bypassed as happen gastric bypass (better results with this of one anastomosis than of two anastomosis, Rouxen-Y) BPD. For patients with a BMI between 30 and 35 restrictive techniques: LAGB and SGL are good but not better than the mixed: RYGB, BAGUA, or SG-DJB with remission from 60 to 100%, minor in the derivative: BPD and above on the IID with a 81% of remission. There are no differences in the metabolic control in comparison to the obese, It is progressively better with DJB, SDS, IID and BAGUA especially in patients who do not require insulin, have less time with disease, have normal C peptide levels, and not so much relation with the initial BMI that is only important to decide the degree of restriction. Although several mechanisms has been suggesed for explaining these results such as caloric intake, hormonal changes, bypass of the anterior or early stimulation of posterior intestine, fundectomy, intestinal gluconeogenesis and others, new ones will appear in the near future. |
| first_indexed | 2024-12-19T07:13:30Z |
| format | Article |
| id | doaj.art-585a469f883b4a9a9438c3c4c81bd839 |
| institution | Directory Open Access Journal |
| issn | 0212-1611 |
| language | English |
| last_indexed | 2024-12-19T07:13:30Z |
| publisher | Arán Ediciones, S. L. |
| record_format | Article |
| series | Nutrición Hospitalaria |
| spelling | doaj.art-585a469f883b4a9a9438c3c4c81bd8392022-12-21T20:31:07ZengArán Ediciones, S. L.Nutrición Hospitalaria0212-161128suppl 22330S0212-16112013000800005Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures?M. Garciacaballero0S. Navarrete1F . Favretti2A. Celik3D. Del Castillo4Facultad de Medicina (Málaga)Universidad Central VenezuelaFacultad de Medicina (Padova)Yeniyuzyil UniversityUniversidad de TarragonaDiabetes mellitus (DM) is a public health problem with a prevalence of 345 million people worldwide that it may double by the year 2030 and have a high costs and mortality. Gastrointestinal surgery is accepted as a form of treatment that was already suggested for obese in 1987 by Pories, confirmed for obese patients by the meta-analysis of Buchwald and the direct comparison of gastric bypass with medical treatment in the study of Schauer that demonstrate a 4 fold greater resolution rate of DM with surgery. Improvement occurs immediately after surgery, before the patients lose weight in with BMI > 35; but there is doubt if the existent evidence is enough to extrapolate these results to patients with BMI < 35 and especially with BMI < 30, in spite that four reviews in patients with this BMI and DM2 demonstrated the same results when stomach, duodenum and part of jejunum is bypassed as happen gastric bypass (better results with this of one anastomosis than of two anastomosis, Rouxen-Y) BPD. For patients with a BMI between 30 and 35 restrictive techniques: LAGB and SGL are good but not better than the mixed: RYGB, BAGUA, or SG-DJB with remission from 60 to 100%, minor in the derivative: BPD and above on the IID with a 81% of remission. There are no differences in the metabolic control in comparison to the obese, It is progressively better with DJB, SDS, IID and BAGUA especially in patients who do not require insulin, have less time with disease, have normal C peptide levels, and not so much relation with the initial BMI that is only important to decide the degree of restriction. Although several mechanisms has been suggesed for explaining these results such as caloric intake, hormonal changes, bypass of the anterior or early stimulation of posterior intestine, fundectomy, intestinal gluconeogenesis and others, new ones will appear in the near future.http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112013000800005&lng=en&tlng=enCirugía diabetes IMC 24-34Procedimientos bariáticos restrictivosProcedimientos bariátricos malabsortivos |
| spellingShingle | M. Garciacaballero S. Navarrete F . Favretti A. Celik D. Del Castillo Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures? Nutrición Hospitalaria Cirugía diabetes IMC 24-34 Procedimientos bariáticos restrictivos Procedimientos bariátricos malabsortivos |
| title | Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures? |
| title_full | Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures? |
| title_fullStr | Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures? |
| title_full_unstemmed | Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures? |
| title_short | Diabetes surgery in type 2 BMI 24-29 vs IMC 30-34 diabetic patients: is there differences among restrictive, malabsorptive and gastric bypass procedures? |
| title_sort | diabetes surgery in type 2 bmi 24 29 vs imc 30 34 diabetic patients is there differences among restrictive malabsorptive and gastric bypass procedures |
| topic | Cirugía diabetes IMC 24-34 Procedimientos bariáticos restrictivos Procedimientos bariátricos malabsortivos |
| url | http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0212-16112013000800005&lng=en&tlng=en |
| work_keys_str_mv | AT mgarciacaballero diabetessurgeryintype2bmi2429vsimc3034diabeticpatientsistheredifferencesamongrestrictivemalabsorptiveandgastricbypassprocedures AT snavarrete diabetessurgeryintype2bmi2429vsimc3034diabeticpatientsistheredifferencesamongrestrictivemalabsorptiveandgastricbypassprocedures AT ffavretti diabetessurgeryintype2bmi2429vsimc3034diabeticpatientsistheredifferencesamongrestrictivemalabsorptiveandgastricbypassprocedures AT acelik diabetessurgeryintype2bmi2429vsimc3034diabeticpatientsistheredifferencesamongrestrictivemalabsorptiveandgastricbypassprocedures AT ddelcastillo diabetessurgeryintype2bmi2429vsimc3034diabeticpatientsistheredifferencesamongrestrictivemalabsorptiveandgastricbypassprocedures |