Long-term resolution of type 2 diabetes after biliopancreatic diversion and duodenal switch procedure: a retrospective analysis from a high-volume institution.

BACKGROUND: Biliopancreatic diversion with duodenal switch (BPD-DS) has been shown to result in better weight loss than other bariatric procedures. Very limited data are available, especially long term, in terms of the resolution of diabetes. OBJECTIVE: The objective of this study was to evaluate the long-term resolution (>5 years) of type 2 diabetes after BPD-DS. SETTING: Academic hospital. METHODS: This is a retrospective chart review of patients with diabetes who underwent primary BPD-DS at our institution from 2010 to 2015. Data for that cohort were collected until January 2021. RESULTS: A total of 151 patients who had met the criteria were included in the final analysis. More than 1 year of follow-up data was available for 94% of patients, and more than 5 years of follow-up data was available for 51%. Most of the patients (98.1%) had either partial or complete resolution or improvement. CONCLUSION: Patients with type 2 diabetes who underwent BPD-DS had profound improvement of their diabetes postoperatively. A significant percentage experienced complete resolution, with most of the remaining patients having demonstrated much improvement in their condition.

Brugada Phenocopy Induced by Recreational Drug Use.

Recreational drugs are commonly abused in all age groups. Intoxication with these substances can induce silent but significant electrocardiographic signs which may lead to sudden death. In this case study, we present a 49-year-old male with no medical comorbidities who came to the emergency department requesting opioid detoxification. Toxicology screen was positive for cocaine, heroin, and cannabis. Initial electrocardiogram (EKG) showed features of a Brugada pattern in the right precordial leads, which resolved within one day into admission. This presentation is consistent with the recently recognized clinical entity known as Brugada phenocopy.