Beyond Insulin: Modified OAGB in Low-BMI Insulin-Resistant and Non-compliant Type 2 Diabetic Patients.

IF 3.1 3区医学 Q1 SURGERY Obesity Surgery Pub Date : 2025-03-01 Epub Date: 2025-02-25 DOI:10.1007/s11695-025-07754-3

Kiranjot Singh Kular, Shubhkaran Singh Gill, Naveen Manchanda, Robert Rutledge, Kuldeepak Singh Kular

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Abstract

Background: Metabolic surgery's role in lower-BMI patients with type 2 diabetes mellitus (T2DM) remains debated, particularly regarding long-term outcomes.

Methods: This retrospective study analyzed 54 patients (BMI 24-30 kg/m²) with poorly controlled T2DM (HbA1c ≥ 10%) who underwent modified one anastomosis gastric bypass between 2016 and 2017. Primary outcomes included glycemic control, weight loss, and complications at 7 years.

Results: Mean preoperative BMI was 26.76 ± 1.82 kg/m², and HbA1c was 12.63 ± 1.67%. Follow-up rates were year 1 (54/54, 100%), year 3 (52/54, 96.3%), year 5 (48/54, 88.9%), and year 7 (36/38, 94.7% of eligible patients). At 7-year follow-up, mean HbA1c decreased to 6.17 ± 0.71% (p < 0.001), and %TWL was 13.1 ± 2.4%. Complete medication elimination occurred in 45 of 54 patients (83.3%) achieving HbA1c < 6.5%. No mortality or major complications were reported.

Conclusions: Modified OAGB demonstrates sustained glycemic control and safety in lower-BMI patients with severe T2DM through 7 years with potential benefits of early surgical intervention.

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胰岛素之外：低bmi胰岛素抵抗和非依从性2型糖尿病患者OAGB的改变

背景：代谢手术在低bmi 2型糖尿病（T2DM）患者中的作用仍有争议，特别是在长期预后方面。方法：本回顾性研究分析了2016 - 2017年间54例（BMI 24-30 kg/m2）控制不良的T2DM （HbA1c≥10%）行改良一期吻合胃旁路术的患者。主要结局包括7年时血糖控制、体重减轻和并发症。结果：术前平均BMI为26.76±1.82 kg/m2， HbA1c为12.63±1.67%。随访率分别为第1年（54/ 54,100%）、第3年（52/ 54,96.3%）、第5年（48/ 54,88.9%）和第7年（36/ 38,94.7%）。在7年的随访中，平均HbA1c降至6.17±0.71% (p)。结论：改进的OAGB在7年的低bmi严重T2DM患者中显示出持续的血糖控制和安全性，并具有早期手术干预的潜在益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity Surgery 医学-外科

CiteScore

5.80

自引率

24.10%

发文量

567

审稿时长

3-6 weeks

期刊介绍： Obesity Surgery is the official journal of the International Federation for the Surgery of Obesity and metabolic disorders (IFSO). A journal for bariatric/metabolic surgeons, Obesity Surgery provides an international, interdisciplinary forum for communicating the latest research, surgical and laparoscopic techniques, for treatment of massive obesity and metabolic disorders. Topics covered include original research, clinical reports, current status, guidelines, historical notes, invited commentaries, letters to the editor, medicolegal issues, meeting abstracts, modern surgery/technical innovations, new concepts, reviews, scholarly presentations and opinions. Obesity Surgery benefits surgeons performing obesity/metabolic surgery, general surgeons and surgical residents, endoscopists, anesthetists, support staff, nurses, dietitians, psychiatrists, psychologists, plastic surgeons, internists including endocrinologists and diabetologists, nutritional scientists, and those dealing with eating disorders.