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KMID : 1033120130020020045
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대한비만대사외과학회지
2013 Volume.2 No. 2 p.45 ~ p.48
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Early Outcome of Gastric Bypass on Insulin Sensitivity and Insulin Secretion in BMI ＜35 kg/m2 with Type 2 Diabetes
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Choi Seung-Ho
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Abstract
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Purpose: Metabolic effects of bariatric surgery in morbidly obese patients (BMI ＞35 kg/m2) with type 2 diabetes have been established. However, effectiveness of bariatric surgery in BMI ＜35 kg/m2 with type 2 diabetes is controversial. Also, change of insulin sensitivity and insulin secretion in BMI ＜35 kg/m2 after operation has not been reported.
Materials and Methods: Five patients who was BMI ＜35 kg/m2 with type 2 diabetes, and received gastric bypass were enrolled. Using oral glucose tolerance test, Matsuda index and HOMA-IR for insulin resistance and insulinogenic index for insulin secretion were checked.
Results: The mean BMI was 27.6±5.4 kg/m2 and HbA1c was 7.4±1.2% with anti-diabetic medication before operation. The mean BMI and HbA1c were decreased to 23.2±5.0 kg/m2 and 5.7±0.4% without anti-diabetic medication 3 months after operation. Preoperative Matsuda index, HOMA-IR and insulinogenic index were 2.5±1.1, 4.7±1.6 and 0.2±0.1 in each. Three months after operation, Matsuda index and HOMA-IR were improved into 5.2±1.8 and 1.5±1.0 (P＜0.05). Also, insulinogenic index was increased into 0.5±0.3 (P＜0.05).
Conclusion: In BMI ＜35 kg/m2 with type 2 diabetes, insulin sensitivity and insulin secretion were much improved after gastric bypass and metabolic surgery might be effective to control type 2 diabetes in patients with BMI ＜35 kg/m2. However, long-term follow-up and case accumu-lation are needed.
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KEYWORD
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Bariatric surgery, Gastric bypass, Non-obese, Insulin secretion, Insulin sensitivity
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