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1 . 2023

Remission of type 2 diabetes mellitus in obese patients after bariatric surgery

Abstract

Obesity is a disease that significantly increases the cardiovascular risk due to the development of associated diseases, including type 2 diabetes mellitus (T2DM). A decrease in body weight leads to an improvement in glycemic control. The most effective method of treating obesity is recognized as the performance of bariatric operations (BO), the consequence of which is not only a decrease in body weight, but also an improvement in glycemic control up to the remission of T2DM. The most common options for BO are longitudinal gastric resection (PRG) and gastric bypass surgery (GS); comparative data on their sugar-lowering effect are few. In this regard, it seems relevant to compare the effectiveness of longitudinal gastrectomy (LG) and GS in achieving remission of T2DM in obese patients.

The purpose of the study. To evaluate the effectiveness of longitudinal gastric resection and gastric bypass surgery in achieving remission of T2DM in obese patients.

Material and methods. 192 patients with a Body Mass Index (BMI) of ≥35 kg/m2 who underwent LG or GS were examined. Of these, 63 (32.8%) were diagnosed with T2DM (women – 36, men – 27). In patients with T2DM who underwent PRG (n=42) or GS (n=21), anthropometric data (BMI, indicators of postoperative body weight dynamics) were evaluated initially and during the follow-up period (at least 2 years), laboratory parameters (glycated hemoglobin, C-peptide, insulin, fasting venous blood glucose), the insulin resistance index (HOMA-IR) was calculated. After 2 years, the criteria for remission of T2DM were evaluated in patients. The data obtained were compared in patients after different types of BO: LG (n=42) or GS (n=21).

Results. There were no significant differences in achieving complete remission of T2DM in obese patients between gastric bypass and longitudinal resection. Achieving and maintaining complete remission of T2DM is possible if the achieved body weight is effectively reduced and maintained.

Keywords:bariatric surgery; remission of diabetes mellitus; longitudinal resection of the stomach; gastric bypass

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

For citation: Mozgunova V.S., Semikova G.V., Volkova A.R., Kovalyova A.A. Remission of type 2 diabetes mellitus in obese patients after bariatric surgery. Endokrinologiya: novosti, mneniya, obuchenie [Endocrinology: News, Opinions, Training]. 2023; 12 (1): 22–7. DOI: https://doi.org/10.33029/2304-9529-2023-12-1-22-27 (in Russian)

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CHIEF EDITOR
CHIEF EDITOR
Ametov Alexander S.
Honored Scientist of the Russian Federation, Doctor of Medical Sciences, Professor, Head of Subdepartment of Endocrinology, Head of the UNESCO Network Chair on the subject «Bioethics of diabetes as a global problem» of the Russian Medical Academy of Continuous Professional Education (Moscow)
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