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

IF 2.9 3区医学 Q1 SURGERY Obesity Surgery Pub 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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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.