"Prior to surgery, the disease severity for these patients was quite significant overall," said Dr. Schauer, "with 65 percent of them requiring oral agents and 27 percent of them requiring insulin as well."

Post surgery, patients had a mean excess weight loss of 60 percent and a body mass index of 34 after 20 months. Fasting plasma glucose and glycoslated hemoglobin concentrations returned to normal levels in 83 percent of patients, while 17 percent of patients markedly improved. Following surgery, 80 percent of patients had a significant reduction in the use of oral anti-diabetic agents and 79 percent had a reduction in their use of insulin.

"The impressive effect of bypass surgery on morbidly obese patients with type 2 diabetes raises an argument for lowering the threshold for surgical intervention to moderate or mild obesity," Dr. Schauer said. "Further investigation demonstrating risk versus benefit for patients with moderate obesity is warranted."

The LGBP procedure involves constructing a small stomach pouch of approximately 15 millimeters (about the size of a plastic medicine cup), and bypassing a small segment of intestines by constructing a Y-shaped limb of small bowel. Patients lose weight because there is a decrease in caloric intake resulting from the reduced reservoir capacity of the small stomach pouch.

Type 2 diabetes is the most common form of diabetes, in which the body is unable to properly use the insulin that it produces. About 80 percent of people with type 2 diabetes are overweight.

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Contact: Frank Raczkiewicz
RaczkiewiczFA@upmc.edu
412-647-3555
University of Pittsburgh Medical Center
2-Oct-2003