Biliopancreatic diversion shows better biochemical results than conventional therapy in Obese T2DM patients

For their study, the researchers included 30 T2DM patients with BMI<35 and investigated them at one, five and ten years after BPD. They further compared the results with those of 30 T2DM patients followed for ten years on pharmacological and/or behavioural conventional therapy. They assessed the anthropometric, biochemical, and clinical records for complications.

Key findings of the study:

• Upon analysis, the researchers found a marked reduction in the mean levels of fasting blood glucose (FBG) and serum glycated hemoglobin (HbA1C) at 1 year after BPD.
• They noted that the values remained slightly above the diabetic range throughout the entire follow-up.
• They observed T2DM remission in about 50% of the cases at 5 and 10 years after the operation.
• However, they noted that 16 patients (53%) developed severe BPD-related complications and ten patients had a surgical revision of the operation.
• They also reported death in the BPD group, one patient for malignant lymphoma and two patients after surgical revision.
• Among the control group, they observed no changes in the diabetic status with FBG and HbA1C mean values higher than those recorded in the BPD patients at any follow-up time.
• They also noted that all T2DM subjects of the control group were alive at the end of the 10-year follow-up.

The authors concluded, "Despite satisfactory long-term metabolic outcomes, these data indicate that BPD should be used with caution as a metabolic procedure in the treatment of T2DM in overweight or class 1 obese patients."

For further information:

DOI: https://doi.org/10.1007/s11695-021-05870-4.