Introduction: The objective of this study is to evaluate the clinical results of the laparoscopic interposition of a segment of ileum into the proximal duodenum associated to a sleeve gastrectomy (II-DSG) in order to treat patients with Type 2 Diabetes Mellitus (T2DM) and BMI 21-29.
Methods: The laparoscopic procedure was performed in 69 patients. 22 were female and 47 male. Mean age was 51 years (41-63). Mean BMI was 25.7 (21.8–29.2). All patients had the diagnosis of T2DM for at least 3 years and evidence of stable treatment with oral hypoglycemic agents and or insulin for at least 12 months. Insulin therapy was been used by 43.5% of the patients. Mean duration of T2DM was 11 years (3-18). Dyslipidemia was diagnosed in 72.5% and hypertension in 66.7%. Nephropathy was characterized in 29% of the patients, retinopathy in 26.1% and neuropathy in 24.6%.
Results: Overall, 95.7% of the patients achieved an adequate glycemic control (A1c < 7) without anti-diabetic medication. A1c below 6 was achieved by 65.2%. Mean post-operative follow-up was 21.7 months (7-42). Mean postoperative BMI was 21.8.kg/m2. There was no conversion to open surgery. Median hospital stay was 3.4 days (2-58). Major postoperative complications were diagnosed in 7.3%. There was no mortality. Fasting glycemia decreased from a mean of 218 to 102mg/dl, postprandial glycemia from 305 to 141 mg/dl and Homa IR from 5.2 to 0.77. All associated co morbidities and complications related to T2DM had a significant improvement or control. Arterial hypertension was controlled in 91.3%. Macroalbuminuria was no longer observed. Microalbuminuria resolved in 85% of the patients. Hypercholesterolemia was normalized in 95% and hypertriglyceridemia in 92% of the patients.
Conclusions: The laparoscopic II-DSG was an effective operation in controlling T2DM in a non-obese (BM
Session: Podium Presentation
Program Number: S085