RESUMEN
BACKGROUND: Control of hyperglycemia in diabetes mellitus through diet, exercise, oral hypoglycemics and insulin has underlined the medical treatment for that disease. Morbidly obese diabetics can be more successfully rendered euglycemic if their excess body weight is reduced and their diets are carefully controlled. METHODS: Roux-en-Y Gastric Bypass has been used as a weight control measure for 205 morbidly obese diabetics over an 8-year period, 1988-1995. Early follow-up has been possible in all patients up to 3 months, and late follow-up has been achieved by phone contact and office visits in 133 patients. RESULTS: Operative mortality occurred in 1/205 patients (0.49%). Major operative morbidity occurred in 14/205 (6.8%). While 46/133 (35%) patients were on insulin preoperatively, only 11/133 (8%) have remained on insulin and 9/11 at lower doses. 64/133 (48%) were on oral hypoglycemics, but only 8/133 (6%) continue their use. 23/133 (17%) were on diet alone or no treatment before surgery, and 91/133 (68%) claimed diet alone or no treatment after surgery. The long-term mean % Excess Body Weight Loss is 55%. CONCLUSIONS: Morbidly obese diabetics undergoing Roux-en-Y Gastric Bypass can experience markedly diminished need for insulin and oral hypoglycemics to control hyperglycemia.
RESUMEN
BACKGROUND: 3,855 patients undergoing Roux-en-Y gastric bypass for morbid obesity between 1988 and 1994 are presented. METHODS: All patients were sent a standard questionnaire reflecting current weight, intervening complications and general health status and 1039 patients responded. Information gleaned from review of these questionnaires and a review of individual charts provided the data for this study. RESULTS: Average weight loss at 1 year was 46 kg and at 5 years was 34.5 kg. Operative mortality was 0.18%. Surgical morbidity rate was 3.4%. Average length of stay for patients hospitalized in 1994 was 3.6 days. The average operating time during that same year was 78 min, and the average hospital charges were $7250. CONCLUSIONS: Roux-en-Y gastric bypass can be performed with relative safety and acceptable morbidity. There is a demonstrable weight loss benefit which is maintained in the majority of patients over a period greater than 5 years. The expense and consumption of provider services are modest, and this procedure remains an excellent alternative for weight control among morbidly obese individuals.