Journal Mobile Options
Table of Contents
Vol. 4, Suppl. 1, 2011
Issue release date: April 2011
Obes Facts 2011;4(suppl 1):13–17

Metabolic Intestinal Bypass Surgery for Type 2 Diabetes in Patients with a BMI < 35 kg/m2: Comparative Analysis of 16 Patients Undergoing either BPD, BPD-DS, or RYGB

Frenken M. · Cho E.-Y.
Department of Surgery, St. Josef Krankenhaus Monheim, Germany

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


Background: Metabolic surgery for type 2 diabetes mellitus in patients with low body mass index (BMI) is a novel concept. Early studies show the surgery to be safe and effective but are inconclusive regarding the most effective procedure. Methods: Metabolic intestinal bypass surgery was performed in n = 16 patients with type 2 diabetes and a BMI < 35 kg/m2 (mean age 56 years, range 36–68; 8 females; mean BMI 32 kg /m2, range 26–34.5). Biliopancreatic diversion with duodenal switch (BPD-DS), biliopancreatic diversion according to Scopinaro (BPD), and Roux-en-Y gastric bypass (RYGB) were performed in 7, 5, and 4 diabetic patients, respectively. Mean preoperative duration of medical antidiabetic therapy was 16 years (range 4–40). Thirteen patients used insulin on average for 6 years (range 1–12), the mean insulin requirement was 92 IU per day (range 30–140). The analysis was accomplished retrospectively from data prospectively collected in our data base. Results: At discharge from hospital, only 3 of the 13 patients who used insulin preoperatively required small amounts of insulin (mean 21 IU per day, range 15–30) to keep fasting and postprandial plasma glucose levels below 200 mg/dl. After 1 year, none of the patients used insulin or oral antidiabetic drugs. The HbA1c level decreased for the total patient population from 8.6% (range 5.8–12.1) preoperatively to 6.0% (range 4.3–7.8), 5.7% (range 4.1–7.6), and 5.6% (range 4.1–7.8) after 3, 6, and 12 months, respectively. The HbA1c levels at 1 year were significantly lower after BPD-DS and BPD than after RYGB (5.2%, range 4.1–6.4 versus 6.7%, range 5.8–7.8, p < 0.01, DHbA1c 1.4%, 95% confidence interval 0.5–2.4). Conclusion: Metabolic intestinal bypass surgery for type 2 diabetes in low BMI patients is effective, with HbA1c levels at 1 year after the operation being significantly lower after BPD-DS or BPD than after RYGB.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50