title: Seven Years of Mini-Gastric Bypass in Type II Diabetes Patients with a Body Mass Index <35 kg/m(2).
abstract: Mini-gastric bypass (MGB) is a safe, effective, and reversible procedure for patients with type II diabetes mellitus (T2DM) and morbid obesity. Less is known, however, about its long-term effects in patients with a body mass index (BMI) <35 kg/m(2).
  
  
  
  From February 2007 to February 2014, 1468 patients underwent MGB at our institution, including 983 with T2DM. Of these, 128 (82 women), of mean age 41.6 ± 10.2 years, had a BMI of 30-35 kg/m(2). Prospectively collected data were analyzed retrospectively. Factors assessed included disease duration, family history, medication use, remission, and biochemical indicators, including fasting plasma glucose, glycosylated hemoglobin (HbA1c), serum insulin, and C-peptide concentrations. Remission of T2DM was defined as HbA1c <6.0 % without medication.
  
  
  
  Prior to surgery, patients had a mean BMI of 33.4 ± 3.3 kg/m(2), mean waist circumference of 104.5 ± 8.2 cm, mean C-peptide concentration of 3.4 ± 1.2 ng/ml, and mean T2DM duration of 6.5 ± 3.1 years. Within 6 months of MGB, 95 % of these patients had attained HbA1c <7 %. Complete remission rates at 1, 2, and 7 years were 64, 66, and 53 %, respectively. Mean HbA1c decreased from 10.7 ± 1.5 % at baseline to 6.2 ± 0.5% at 1 year, 5.4 ± 1.2 % at 3 years, and 5.7 ± 1.8 % at 7 years. No deaths occurred, but two (1.6 %) patients experienced major complications.
  
  
  
  MGB provides good, long-term control of T2DM in patients with class I obesity. Early intervention results in higher remission rates.
authors.affiliation: Kular Medical Education and Research Society, Kular Group of Institutes, NH 1, Bija, Khanna, Ludhiana, Punjab, 141412, India. drkskular@gmail.com.
authors.forename: Kuldeepak S
authors.initials: KS
authors.lastname: Kular
authors.affiliation: Bariatric Surgery, Kular Hospital, NH 1, Bija, Khanna, Ludhiana, Punjab, India.
authors.forename: Naveen
authors.initials: N
authors.lastname: Manchanda
authors.affiliation: Kular Group of Institutes, NH 1, Bija, Khanna, Ludhiana, Punjab, 141412, India.
authors.forename: Gurpreet K
authors.initials: GK
authors.lastname: Cheema
mesh_terms: D000328:Adult; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology / Q000601:surgery*; D012074:Remission Induction; D012189:Retrospective Studies; D015431:Weight Loss
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: Bariatric surgery; Body mass index; Laparoscopic mini-gastric bypass; Morbidly obese; Type II diabetes mellitus