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Type 2 diabetes mellitus outcomes after laparoscopic gastric bypass in patients with BMI <35 kg/m2 using strict remission criteria: early outcomes of a prospective study among Mexicans

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Abstract

Background

Mild obesity (BMI 30–34.9 kg/m2) is highly prevalent worldwide and is associated with type 2 diabetes mellitus. The efficacy of bariatric surgery remains unclear, including among Mexicans. The criteria for diabetes remission are inconsistent, as they are based on different thresholds for glycated hemoglobin, with remission rates ranging from 43 to 73%.

Methods

Mildly obese patients with type 2 diabetes mellitus who underwent laparoscopic gastric bypass were prospectively analyzed. The primary objective was to determine the impact of surgery on their metabolic profiles. Demographic, clinical, and biochemical parameters were measured at baseline and at 3, 6, 9, 12, and 18 months. Diabetes remission rate was defined as an HbA1c <5.7%. Complications within 30 days and weight loss (% total weight loss) were also analyzed.

Results

Twenty-three Mexican patients underwent surgery. Of the 19 patients, evaluable at 18 months, nine (47.4%) achieved complete diabetes remission, seven (36.8%) showed partial remission, and three (15.8%) showed improvement. Significant improvements in lipid profile, cardiovascular risk, blood pressure, and every metabolic parameter were observed, beginning at the first month and throughout the study. The final total percentage weight loss was 24.9%. Three patients (13%) experienced complications, but none required reoperation or died.

Conclusion

Laparoscopic gastric bypass is a safe and effective method to improve the metabolic profile of mildly obese Mexican patients with type 2 diabetes mellitus, inducing high remission rates even when the strictest model is used.

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Authors and Affiliations

  1. The Obesity Clinic at Hospital General Tláhuac, Avenida La Turba 655, Colonia Villa Centro Americana y del Caribe, Delegación Tláhuac, 13250, Mexico City, Mexico

    Omar Espinosa, Omar Pineda, Hernan G. Maydón, Elisa M. Sepúlveda, Lizbeth Guilbert, Mónica Amado & Carlos Zerrweck

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  1. Omar Espinosa
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Correspondence to Carlos Zerrweck.

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Conflict of interest

Omar Espinosa, Omar Pineda, Hernan G. Maydón, Elisa M. Sepúlveda, Lizbeth Guilbert, Mónica Amado, and Carlos Zerrweck declare that they have no conflicts of interest or financial ties to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institution and/or national research committee and with 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in this study.

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Espinosa, O., Pineda, O., Maydón, H.G. et al. Type 2 diabetes mellitus outcomes after laparoscopic gastric bypass in patients with BMI <35 kg/m2 using strict remission criteria: early outcomes of a prospective study among Mexicans. Surg Endosc 32, 1353–1359 (2018). https://doi.org/10.1007/s00464-017-5815-3

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