Long-term clinical and functional impact of biliopancreatic diversion on type 2 diabetes in morbidly and non–morbidly obese patients

Abstract Setting Obesity surgery has been proposed as a treatment option for diabetic patients with body mass index (BMI) 2 , but the efficacy of metabolic surgery has not been conclusively determined. Objectives To evaluate the long-term metabolic outcome of non–morbidly obese (NMO) patients with type 2 diabetes (T2D) after biliopancreatic diversion (BPD). Material and methods Two groups of T2D patients with different degree of obesity (NMO, 17 cases, BMI 25–35 kg/m 2 ; and morbidly obese [MO], 13 cases, BMI>35 kg/m 2 ) were studied before and at 1 and 5 years after BPD in a university hospital setting. Insulin secretion was assessed by acute insulin response (AIR) to intravenous glucose and by insulinogenic index (IGI). Results In all MO patients, T2D was remitted or controlled (1 case) at 1 year and results were maintained at 5 years; AIR (μU/mL) and IGI (μU/mg) improved ( P Conclusions After BPD, restoration of β-cell secretion/production plays a pivotal role in determining postoperative T2D remission.