The effects of biliopancreatic diversion on type 2 diabetes mellitus in patients with mild obesity (BMI 30-35 kg/m 2) and simple overweight (BMI 25-30 kg/m 2): A prospective controlled study

Background: Beneficial effects of BPD on T2DM in BMI >35 kg/m ² patients are far better than those in patients with BMI 25-35. This study was aimed at investigating if a similar difference exists between patients with mild obesity (OB, BMI 30-35) or simple overweight (OW, BMI 25-30). Methods: Fifteen OB (six M) and 15 OW (13 M), diabetic for ≥3 years, with HbA1c ≥7.5% despite medical therapy, underwent BPD. OB/OW: age 55.1±8.0/57.8±6.7 years, BMI 33.1±1.5/28.0±1.3 kg/m ², diabetes duration 11.6±8.0/11.1±6.1 years, insulin therapy 4/8 p. FSG and HbA1c were determined preoperatively and up to 2 years. Insulin resistance and beta-cell function were explored by means of HOMA-IR and IVGTT (AIR). Thirty-eight diabetic patients on medical therapy served as controls. Results: Mean BMI stabilized around 27 since the 4th month in OB, and 24 since 1st month in OW. FSG in OB/OW preop, 1, 12, 24 months: 234±76/206±62 mg/dL, 154±49/176±75, 131±32/167±48, 134±41/154±41 (cross-sectional n.s. at all times); HbA1c: 9.5±1.6/9.1±1.3, 7.3±1.1/7. 3±1.2, 5.9±0.6/7.1±1.1 (p