Effect of Laparoscopic Roux-en-Y Gastric Bypass in Type 2 Diabetes Mellitus with BMI<35kg/m2

Objective To evaluate the efficacy and safety of laparoscopic Roux-en-Y gastric bypass(LRYGB)in type 2 diabetes mellitus(T2DM)with body mass index(BMI) 35 kg/m2.Methods LRYGB was performed in 26T2DM patients with BMI35 kg/m2 in our hospital from January 2010 to December 2011.The patients were followed up for 1 year.Preoperative data including BMI,waist circumference,fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG)and glycosylated hemoglobin(HbA1c)were compared with the data collected at 1 week,1,3,6 and 12postoperative months.Results All procedures were completed laparoscopically.The mean operation time was 150 min,the mean bleeding was 50ml,and the mean postoperative hospital stay was 10 days.No mortality and significant surgical complications occurred.The comparison of pre-and postoperative data demonstrated that there was substantial drop in BMI from32.21±2.30 kg/m2 to 29.12±2.07 kg/m2 at 1 month,and to 26.32±1.85 kg/m2 at 12 months(P0.05).Waist-hip ratio decreased consistently from0.96±0.06to 0.92±0.70 at 3 months and to 0.82±0.61 at 12 months(P0.05).Both FPG and 2 h PG were significantly decreased at 1 week after operation(FPG:11.56±3.05 mmol/L vs.9.30±1.98 mmol/L,2 h PG:16.69±3.02 mmol/L vs.12.78±2.27 mmol/L,both P0.05),and(FPG:11.56±3.05 mmol/L vs.5.45±1.52 mmol/L,2 h PG:16.69±3.02 mmol/Lvs.8.08±1.87 mmol/L)at 12 months.Significant reduction in HbA1c from9.69% ±1.85%to 7.00%±1.20%at 3 months,to 6.61%±1.12%at 6 months,and to5.59%±1.02%at 12 months was observed(P0.05).Conclusion LRYGB is a safe and effective treatment alternative for T2DM with a potential of complete remission of the disease,at least in the short term.Its longterm efficacy warrants further studies.