title: The long-term impact of biliopancreatic diversion on glycemic control in the severely obese with type 2 diabetes mellitus in relation to preoperative duration of diabetes.
abstract: BACKGROUND
  Bariatric surgery has been shown to be effective in severely obese patients with type 2 diabetes mellitus (T2DM).
  
  
  OBJECTIVE
  Evaluate the long-term efficacy of biliopancreatic diversion (BPD) for the treatment of T2DM depending on the preoperative duration of T2DM.
  
  
  METHODS
  University Hospital.
  
  
  METHODS
  Retrospective analysis investigating 2 subsets of severely obese patients who had undergone BPD from 1984 to 1995. The first included 52 patients with a preoperative T2DM duration of ~1 year (SD group - 49 on oral agents and 3 on insulin), and the second included 68 patients who had been diabetic for>5 years before BPD (LD group - 52 on oral agents and 16 on insulin). Postoperatively, T2DM was regarded as in remission when fasting serum glucose (FSG) was lower than 100 mg/dL on regular diet and without antidiabetic therapy.
  
  
  RESULTS
  In the SD patients, the number of individuals without T2DM remission were lower both at 5-10 (0/31, 0% of patients, versus 8/54, 15% of patients, p<.04) and at>15 years (1/28, 3% of patients, versus 10/41, 24% of patients, p<.0012). Furthermore, after BPD, the number of patients with dyslipidemia strongly reduced (p<.001) in both groups, values at 5-10 years remaining very similar to those observed at>15 years.
  
  
  CONCLUSIONS
  These results indicate that severely obese patients with longer T2DM duration have a worse metabolic outcome maintained at long and very long term following BPD.
authors.affiliation: Department of Surgery, University of Genova, Azienda Ospedale-Università San Martino, Genova, Italy.
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Camerini
authors.affiliation: Department of Surgery, University of Genova, Azienda Ospedale-Università San Martino, Genova, Italy.
authors.forename: Francesco S
authors.initials: FS
authors.lastname: Papadia
authors.affiliation: Department of Surgery, University of Genova, Azienda Ospedale-Università San Martino, Genova, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Carlini
authors.affiliation: Department of Surgery, University of Genova, Azienda Ospedale-Università San Martino, Genova, Italy.
authors.forename: Mariafrancesca
authors.initials: M
authors.lastname: Catalano
authors.affiliation: Department of Surgery, University of Genova, Azienda Ospedale-Università San Martino, Genova, Italy. Electronic address: adami@unige.it.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Adami
authors.affiliation: Department of Surgery, University of Genova, Azienda Ospedale-Università San Martino, Genova, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: Scopinaro
mesh_terms: D000328:Adult; D015904:Biliopancreatic Diversion / Q000379:methods*; D001786:Blood Glucose / Q000378:metabolism*; D015190:Blood Glucose Self-Monitoring / Q000379:methods*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000601:surgery*; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin
keywords: Bariatric surgery; Biliopancreatic diversion; Diabetes resolution; Retrospective study; Type 2 diabetes; Very long term results