Obese patients with diabetes mellitus type 2 undergoing gastric bypass in Roux-en-Y: analysis of results and its influence in complications.
BACKGROUND
About 90% of type 2 diabetic patients are obese or overweight. The obvious clinical improvement observed with surgeries, such as Roux-en-Y gastric bypass, has opened space for research by different factors than only weight loss, as responsible for the return to euglycemia and reduction of medication use.


OBJECTIVE
To evaluate the efficacy and safety of surgical treatment of diabetes in obese patients with BMI above 35 kg/m2 underwent to gastric bypass, for the control of diabetes, weight loss, improvement of laboratory findings and complications of diabetes.


METHODS
The protocol was implemented in three stages: initial, after losing 10% of weight, and after a year.


RESULTS
Seventeen patients who have lost weight in 10% were included in the surgical protocol. From the total, 11.8% continued needing medication (p <0.001). The time for weight loss was a month with significant reduction in fasting glucose, HOMA-IR index, insulin, HbA1c, hemoglobin, AST, urea and C-peptide and there was no variation in hematocrit, albumin, ALT and creatinine. With a year of monitoring, the surgical group showed a significant difference in weight, BMI, blood glucose, HbA1c, C-peptide, insulin and HOMA-IR. The percentage of patients with neuropathy (31.3%) was lower than the number of cases at baseline (52.9%) (p> 0.05).


CONCLUSIONS
Gastric bypass with Roux-en-Y derivation is a safe procedure, with good results in control of diabetes type 2 in obese patients with BMI above 35 kg/m2.
Jorge Luiz de Mattos
JL
Zeve
Carlos Alberto Bezerra
CA
Tomaz
Paulo Afonso Nunes
PA
Nassif
João Henrique
JH
Lima
Luciana Regina Zeve
LR
Sansana
Christiana Haddad
CH
Zeve
D000328:Adult; D000713:Anastomosis, Roux-en-Y; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications* / Q000601:surgery*; D011446:Prospective Studies; D016896:Treatment Outcome