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Antidiabetic efficacy of obesity surgery in Germany: a quality assurance nationwide survey.
Weiner, Rudolf; El-Sayes, Islam; Manger, Thomas; Weiner, Sylvia; Lippert, Hans; Stroh, Christine.
Afiliação
  • Weiner R; Surgery Department, Sachsenhausen Hospital, Frankfurt am Main, Germany. Electronic address: rweiner@khs-ffm.de.
  • El-Sayes I; Surgery Department, Sachsenhausen Hospital, Frankfurt am Main, Germany.
  • Manger T; Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Gera, Germany; Institute of Quality Assurance in Surgery gGmbH, University Magdeburg, Magdeburg, Germany.
  • Weiner S; Surgery Department, Sachsenhausen Hospital, Frankfurt am Main, Germany.
  • Lippert H; Department of General, Abdominal and Vascular Surgery, Otto-von-Guericke University, Magdeburg, Germany.
  • Stroh C; Department of General, Abdominal and Pediatric Surgery, Municipal Hospital, Gera, Germany; Institute of Quality Assurance in Surgery gGmbH, University Magdeburg, Magdeburg, Germany.
Surg Obes Relat Dis ; 10(2): 322-7, 2014.
Article em En | MEDLINE | ID: mdl-24182447
ABSTRACT

BACKGROUND:

Obesity and diabetes usually co-exist. Obesity surgery seems to offer solutions for both. The objective of this study was to show the effect of obesity surgery on the diabetic profile.

METHODS:

Data on obesity surgery in Germany (2005-2011) were collected from the Institute of Quality Assurance at the research university. Follow-up of the diabetic profile at 1, 2, and up to 6 years after surgery was done.

RESULTS:

Among 17,670 patients, 5,506 (31.2%) were diabetics. Follow-up was accomplished in 87.4%, 82.5%, and 68.9% of eligible patients at 1, 2, and up to 6 years, respectively, after surgery. Of the study participants, 38.2% were insulin-treated (IT) patients and 61.8% were noninsulin-treated patients (NIT). Of the patients' procedures, 2878 (52.3%) Roux-en-Y gastric bypasses (RYGB), 1711 (31.1%) sleeve gastrectomies (SG), 679 (12.3%) laparoscopic adjustable gastric bands (LAGB), 165 (3%) biliopancreatic diversions with duodenal switch (BPD/DS), and 68 (1.3%) biliopancreatic diversions (BPD) were performed. Female gender percentage and mean body mass index (BMI) were significantly higher in the RYGB and LAGB groups. Mean age was significantly higher in BPD/DS group. At 1 year, remission/improvement (RI) percentage was 83.5%, 82.5%, 67.8%, 93.4%, and 84.8% after RYGB, SG, LAGB, BPD, and BPD/DS, respectively. At 2 years, RI% was 84.9%, 79.5%, 67.7%, 94.5%, and 90.9% after RYGB, SG, LAGB, BPD, and BPD/DS, respectively. At late follow-up, RI% was 83.2%, 59.5%, 58.9%, 100%, and 86.4% after RYGB, SG, LAGB, BPD, and BPD/DS, respectively. IT patients showed insignificantly higher RI% than NIT patients at all follow-up points. Malabsorptive procedures (RYGB, BPD, and BPD/DS) showed a significantly higher RI% than restrictive procedures (LAGB and SG) at late follow-up.

CONCLUSION:

Obesity surgery has promising antidiabetic efficacy, especially in IT patients. Malabsorptive procedures show higher, gradually descending, but durable antidiabetic efficacy.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Garantia da Qualidade dos Cuidados de Saúde / Diabetes Mellitus / Cirurgia Bariátrica / Obesidade Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Surg Obes Relat Dis Ano de publicação: 2014 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Garantia da Qualidade dos Cuidados de Saúde / Diabetes Mellitus / Cirurgia Bariátrica / Obesidade Limite: Adult / Female / Humans / Male / Middle aged País/Região como assunto: Europa Idioma: En Revista: Surg Obes Relat Dis Ano de publicação: 2014 Tipo de documento: Article