New Frontiers on Bariatric Surgical Procedures: Classical Bypass for Type-2 Diabetic Patients With Obesity Grade I

New Frontiers on Bariatric Surgical Procedures. Classical Bypass for Type 2 Diabetic Patients With BMI Between 30 and 34.9 kg/m2

Bariatric surgery leads to remission of type 2 diabetes in morbid obese patients in 80% (Roux-en-Y gastric bypass)to 90% (biliopancreatic diversion and duodenal switch) of cases. The current consensus supports bariatric surgical treatment for diabetic patients with BMI as low as 35kg/m2 but it has questioned that lower body mass patients might benefit of the surgery as well.

This study is proposed to describe the effects of Roux-en-Y gastric bypass in mild obese (BMI 30-35) human volunteers on incretins, insulin production and sensitivity and its clinical (diabetic chronic complications) and metabolic impact.

Bariatric surgery leads to remission of type 2 diabetes in morbid obese patients in 80% (Roux-en-Y gastric bypass)to 90% (biliopancreatic diversion and duodenal switch) of cases; most of the remainder achieve better glycemic control, even if they regain weight. The current consensus supports bariatric surgical treatment for diabetic patients with BMI as low as 35kg/m2 but it has questioned that lower body mass patients might benefit of the surgery as well.

Actually, many clinical researchers worldwide would consider a lower limit BMI of 30kg/m2, i.e., any grade of obesity.

This study is proposed to describe the effects of Roux-en-Y gastric bypass (Fobi-Capella technique, adapted to create a larger gastric pouch, about 80ml)in mild obese (BMI 30-35) human volunteers on incretins, insulin production and sensitivity and its clinical (diabetic chronic complications) and metabolic impact.

Inclusion Criteria:

• Obesity grade I (BMI 30-34,9)
• Weight variance less than 5% in the last 3 months.
• Previous diagnosis of diabetes type 2.
• Insulin requirement, alone or along with oral agents
• Capacity to understand the procedures of the study.
• To agree voluntarily to participate of the study, signing an informed consent.

Exclusion Criteria:

• Positive Anti-GAD antibodies
• Laboratorial signal of probable failure of insulin production, i. e., seric peptide C lesser than 1 ng/mL.
• History of hepatic disease like cirrhosis or chronic active hepatitis.
• Kidney dysfunction (creatinine > 1,4 mg/dl in women and > 1,5 mg/dl in men).
• Hepatic dysfunction: aspartate aminotransferase or alanine aminotransferase 3x above upper normal limit.
• Recent history of neoplasia (< 5 years).
• Use of oral or injectable corticosteroids for more than consecutive 14 days in the last three months.