Laparoscopic mini-gastric bypass for type 2 diabetes: the preliminary report

Type 2 diabetes mellitus (T2DM) has become an epidemic health problem worldwide. Compared to Western countries, in Asia, T2DM occurs in patients with a lower body mass index (BMI) due to central obesity and decreased pancreatic β-cell function. The efficacy of laparoscopic mini-gastric bypass (LMGB) in obese patients with T2DM has been proven by numerous studies. Treatment outcomes of LMGB for non-obese T2DM patients are also estimated to be excellent. The aim of the present pilot study was to evaluate the efficacy and safety of LMBG in non-obese T2DM patients (BMI 25-30 kg/m(2)).

Ten consecutive patients underwent LMGB at our hospital from August 2009 to October 2009. Preoperative data including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and 2 h postprandial glucose (2-h PPG) were compared with data collected at 1, 3, and 6 postoperative months.

All procedures were completed laparoscopically. Mean age of the patients was 46.9 years, mean BMI was 27.2 kg/m(2), mean operative time was 150.5 min, and mean postoperative hospital stay was 5.3 days. Neither mortality nor major complications occurred. Mean preoperative glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), 2-h PPG, and C-peptide level were 9.7%, 222 mg/dl, 343 mg/dl, and 2.78 ng/ml, respectively. At the sixth postoperative month, HbA1c, FPG, 2-h PPG, and C-peptide level measured 6.7%, 144 mg/dl, 203 mg/dl, and 2.18 ng/ml.

This preliminary study demonstrated the resolution of hyperglycemia in 70% of non-obese T2DM patients (BMI 25-30 kg/m(2)). Although long-term follow-up data are required, early operative outcomes were satisfactory in terms of glycemic control and safety of the procedure.