ECE2014 Poster Presentations Obesity (53 abstracts)
Improvement of type 2 diabetes after gastric banding and gastric bypass: medium-term outcomes
Ana Rita Caldas 1 , Teresa Pereira 1 , Susana Garrido 1 , Claúdia Freitas 1 , Cláudia Amaral 1 , André Carvalho 1 , Isabel Silva 2 , Fernando Pichel 1 , Carla Silva 1 , António Sérgio Silva 1 , Carlos Nogueira 1 , Jorge Santos 1 , Mário Marcos 1 & Maria Helena Cardoso 1
1Centro Hospitalar do Porto, Porto, Portugal; 2Universidade Fernando Pessoa, Porto, Portugal.
Introduction: Bariatric surgery is associated with improvement and often resolution of type 2 diabetes mellitus (T2DM). Our aim was to compare the effects of gastric banding (GB) and gastric bypass (GBP) in glucose homeostasis in obese patients with T2DM.
Methods: From 1995 to 2011, 83 diabetic patients underwent bariatric surgery at our hospital: 37 underwent GB (73% females, mean age 48.3±9.2) and 46 underwent GBP (82.6% females, mean age 49.4±9). We compared prospectively the anthropometric and metabolic parameters and DM resolution until the third year after surgery.
Results: The mean follow-up period was 2.7 years for GB and 1.8 years for GBP. Before surgery, GB patients had a higher BMI than GBP patients (49.3±9.8 vs 45.1±5.3 Kg/m2). Weight loss in the first, second and third year after surgery was 37.8, 40.4 and 53.3% after GB and 63, 65 and 62.2 after GBP (no significant difference at third year). HOMA-IR improved from 7.8±3.6 to 4.3±3.1, 3.0±1.2 and 2.0±1.1 at first, second and third years after GB and from 7.6±2.5 to 1.6±0.7, 1.7±1.0 and 1.6±0.5 after GBP (no significant difference at third year). HOMA-RI correlated significantly with %EWL at first, second and third years after GB but only at second and third years after GBP. T2DM remission rate was not significantly different between GB and GBP: 56.8% vs 58.7% at first year, 70.6% vs 65.5% at second year and 71.4% vs 55.6% at third year.
Conclusions: Weight loss was slower with GB, but at the third year there weren’t significant differences between groups. HOMA-RI improved gradually with GB; in GBP it improved mainly in the first year, as occurred with weight loss. HOMA-RI correlated significantly with %EWL at all times (except at first year for GBP patients), suggesting a weight loss-dependent effect. T2DM remission was not significantly different between groups.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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