Diabetes Remission After RYGBP and RYGBP With Fundus Resection

RYGBP vs RYGBP With Fundus Resection for Morbid Obese Patients With Type 2 Diabetes. Evaluation of the Gastric Fundus in Glycemic Control. A Randomized Clinical Trial.

The goal of this randomized clinical trial is to evaluate glycemic control in patients with morbid obesity and type 2 diabetes after Roux-en-Y gastric bypass (RYGBP) and RYGBP with fundus resection. The main questions to answer are:

• Rate of diabetes remission and the role of the gastrointestinal hormones
• Whether fundus resection leads to improved glycemic control

Patients will randomly undergo typical RYGBP or RYGBP with fundus resection. Gastrointestinal hormones profile [ghrelin, glucagon-like peptide-1 (GLP-1), peptide YY (PYY), glucagon], glucose levels and insulin response will be measured preoperatively, at 6 months and at 12 months, during 120-min OGTT.

Inclusion Criteria:

• morbid obesity (ΒΜΙ ≥ 40)
• type II diabetes mellitus (T2DM)
• duration of T2DM shorter than 8 years

Exclusion Criteria:

• pregnancy
• type 1 diabetes
• previous gastrointestinal surgeries
• alcohol consumption
• depression
• no compliance