Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA)

• Autores: Manuel García Caballero, José Manuel Martínez Moreno, José Antonio Toval Mata, Francisco Miralles Linares, Alfredo Mínguez Mañanes, Diego Osorio Fernández, José María Mata Martín, Alexander Reyes Ortiz
• Localización: Nutrición hospitalaria: Organo oficial de la Sociedad española de nutrición parenteral y enteral, ISSN-e 1699-5198, ISSN 0212-1611, Vol. 28, Nº. Extra 2, 2013 (Ejemplar dedicado a: CIRUGÍA DIABETES IMC 24-34; ¿CÓMO Y POR QUÉ?), págs. 35-46
• Idioma: inglés
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• Resumen

  • Background:

    Although bariatric surgery proved to be a very effective method in the treatment of patients in whose pancreas still produce insulin (type 2 diabetes), the accompanied metabolic syndrome and their diabetes complications, there is no information on the effect of this type of surgery in BMI24-34 patients when pancreas do not produce insulin at all (type 1, LADA and long term evolution type 2 diabetes among others).

    Patients and methods:

    We report preliminary data of a serie of 11 patients all with a C-peptide values below 0.0 ng/ml. They were followed for 6 to 60 months (mean 19 months) after surgery. We studied the changes in glycemic control, evolution of the metabolic syndrome and diabetes complications after one anastomosis gastric bypass (BAGUA).

    Results:

    All values relative to glycemic control were improved HbA1c (from 8.9 ± 0.6 to 6.7 ± 0.2%), FPG (Fasting Plasma Glucose) [from 222.36 ± 16.87 to 94 ± 5 (mg/dl)] as well as the daily insulin requirement of rapid (from 40.6 ± 12.8 to 0 (U/d) and long-lasting insulin (from 41.27 ± 7.3 U/day to 15.2 ± 3.3 U/day). It resolved 100% of the metabolic syndrome diseases as well as severe hypoglycaemia episodes present before surgery and improved some serious complications from diabetes like retinopathy, nephropathy, neuropathy, peripheral vasculopathy and cardiopathy.

    Conclusions:

    Tailored one anastomosis gastric bypass in BMI 24-34 C peptide zero diabetic patients eliminated the use of rapid insulin, reduced to only one injection per day long-lasting insulin and improved the glycemic control. After surgery disappear metabolic syndrome and severe hypoglycaemia episodes and improves significantly retinopathy, neuropathy, nephropathy, peripheral vasculopathy and cardiopathy.