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Surgical Endoscopy
Published in: Surgical Endoscopy 5/2019

01-05-2019

Ileal interposition coupled with duodenal diverted sleeve gastrectomy versus standard medical treatment in type 2 diabetes mellitus obese patients: long-term results of a case–control study

Authors: Diego Foschi, Luca Sorrentino, Igor Tubazio, Consuelo Vecchio, Tarcisio Vago, Maurizio Bevilacqua, Andrea Rizzi, Fabio Corsi

Published in: Surgical Endoscopy | Issue 5/2019

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Abstract

Background

Randomized controlled trials have demonstrated that bariatric surgery is effective in obtaining remission of type 2 diabetes mellitus (T2DM) in obese patients, yet no data exist in the literature from prospective studies with ileal interposition with duodenal diversion sleeve gastrectomy (II-DD-SG). The aim of this case–control study is to investigate if II-DD-SG is superior to medical treatment in T2DM obese patients.

Methods

Thirty obese patients (BMI > 30) affected by T2DM were recruited for surgery (II-DD-SG) between 2008 and 2011 and were matched with an equal control group which received standard medical treatment. Anthropometric measures, glucose metabolism, cardiovascular risk factors were determined baseline and during follow-up. The primary end point was T2DM remission; reduction of body weight, BMI, and cardiovascular risk factors were secondary end-points.

Results

Shortly after II-DD-SG, normalization of glucose plasma levels and glycated hemoglobin was observed followed by a significant decrease in body weight and BMI. At one-year follow-up, insulin resistance strongly declined as did insulin plasma levels. Complete remission was observed in 26 patients (86%); 2 (6.6%) had partial remission, and two (6.6%) were still diabetic. After 5 years, 17 of 25 patients on follow-up (68%) showed complete remission of T2DM and 56% had remission of cardiovascular risk factors. Only two patients receiving medical treatment showed complete remission of T2DM (p < 0.0001 versus II-DD-SG). No significant changes of anthropometric parameters and lipid metabolism were recorded.

Conclusions

II-DD-SG is an effective surgical procedure, able to induce complete and prolonged remission of T2DM in obese patients as opposed to medical treatment.
Appendix
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Metadata
Title
Ileal interposition coupled with duodenal diverted sleeve gastrectomy versus standard medical treatment in type 2 diabetes mellitus obese patients: long-term results of a case–control study
Authors
Diego Foschi
Luca Sorrentino
Igor Tubazio
Consuelo Vecchio
Tarcisio Vago
Maurizio Bevilacqua
Andrea Rizzi
Fabio Corsi
Publication date
01-05-2019
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 5/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-018-6443-2

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