The long-term impact of biliopancreatic diversion on glycemic control in the severely obese with type 2 diabetes mellitus in relation to preoperative duration of diabetes.

Background: Bariatric surgery has been shown to beeffective in severely obese patients with type 2 diabetes mellitus(T2DM). Objective: Evaluate the long-term efficacy of biliopancreatic diversion (BPD) for the treatmentof T2DM depending on the preoperative duration of T2DM. Setting: University Hospital.Methods: Retrospective analysi sinvestigating 2 subsets of severely obese patients who had undergone BPD from1984 to1995.The first included 52 patients witha preoperative T2DM duration of 1 year (SD group – 49 on orala gents and 3 oni nsulin),and thesecond included 68 patients who had been diabeticfor 4 5 years before BPD (LD group – 52 on ora lagents and 16on insulin). Postoperatively, T2D T2DM was regarded as in remission when fasting serum glucose(FSG) was lower than100mg/dLon regular diet and without antidiabeti ctherapy. Results: In the SD patients ,the numbe ro findividuals without T2DM remission were lower both at 5–10 (0/31,0%of patients,versus 8/54,15 %of patients, p o .04) and at 4 15 years (1/28,3%of patients, versus10/41,24%ofpatients, p o .0012). Furthermore,afterBPD,thenumberofpatients with dyslipidemiastronglyreduced(p o .001) inbothgroups,valuesat5–10 years remaining very similar to those observedat 4 15 years. Conclusion: These reults indicate that severely obese patients with longer T2DMduration have a worse metabolic outcome maintained at long and very long term following BPD.