Endocrine Abstracts

Objective: To evaluate the gastric bypass effect in type 2 diabetic patients with morbid obesity, on the following terms: diabetes evolution, 10 years estimated cardiovascular risk and quality of life

Methods: Cohort study with intrasubject measures (before–after) in a sample of patients with morbid obesity and type 2 diabetes who underwent gastric bypass. Demographic characteristics, anthropometric parameters, cardiovascular risk factors and surgical complications were analyzed. The estimation of cardiovascular disease risk at 10 years was determined according to the Framingham Risk Score and the impact on the quality of life using the BAROS test (Bariatric Analysis and Reporting Outcome System).

Results: 41 patients were included (63.4% female), with mean age 45.62±8.37 years and BMI before surgery 51.96±8.69 kg/m². In most cases duration of diabetes was <10 years, 92.6% used oral hypoglycemic therapy and with not known chronic complications. Mean HbA1c before surgery was 7.55±1.18 and 5.33±0.59% at 2 years. Four months after the bypass only 12 patients maintained the diagnosis of diabetes. Two years after surgery the percentage of weight lost was 65.81% and the resolution of hypertension, dyslipidemia and diabetes occurred in 76.67, 89.29, and 92.68% cases respectively (P<0.001). According to the Framingham Risk Score, estimated 10 years cardiovascular risk was greater than 20% in 35.9% of cases before surgery. Mean risk decreased from 15.84% at baseline to 4.32% two years after surgery (P<0.001). 14.6% of patients had early complications and 19.5% developed later complications. BAROS scale was excellent in 36.8% of cases, very good in 36.7% and good in 21.1% at 2 years.

Conclusions: In morbid obese patients with type 2 diabetes, gastric bypass was shown as an effective tool in the early resolution of diabetes, besides its beneficial effects on 10 years estimated cardiovascular risk and quality of life.