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Background <p>Metabolic surgery’s role in lower-BMI patients with type 2 diabetes mellitus (T2DM) remains debated, particularly regarding long-term outcomes.</p> Methods <p>This retrospective study analyzed 54 patients (BMI 24–30&#xa0;kg/m<sup>2</sup>) with poorly controlled T2DM (HbA1c ≥ 10%) who underwent modified one anastomosis gastric bypass between 2016 and 2017. Primary outcomes included glycemic control, weight loss, and complications at 7&#xa0;years.</p> Results <p>Mean preoperative BMI was 26.76 ± 1.82&#xa0;kg/m<sup>2</sup>, and HbA1c was 12.63 ± 1.67%. Follow-up rates were year 1 (54/54, 100%), year 3 (52/54, 96.3%), year 5 (48/54, 88.9%), and year 7 (36/38, 94.7% of eligible patients). At 7-year follow-up, mean HbA1c decreased to 6.17 ± 0.71% (<i>p</i> &lt; 0.001), and %TWL was 13.1 ± 2.4%. Complete medication elimination occurred in 45 of 54 patients (83.3%) achieving HbA1c &lt; 6.5%. No mortality or major complications were reported.</p> Conclusions <p>Modified OAGB demonstrates sustained glycemic control and safety in lower-BMI patients with severe T2DM through 7&#xa0;years with potential benefits of early surgical intervention.</p>

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Beyond Insulin: Modified OAGB in Low-BMI Insulin-Resistant and Non-compliant Type 2 Diabetic Patients

  • 期刊论文

  • 发表日期：

    2025年2月25日

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  • Kiranjot Singh Kular,
  • Shubhkaran Singh Gill,
  • Naveen Manchanda,
  • Robert Rutledge,
  • Kuldeepak Singh Kular

摘要

Background

Metabolic surgery’s role in lower-BMI patients with type 2 diabetes mellitus (T2DM) remains debated, particularly regarding long-term outcomes.

Methods

This retrospective study analyzed 54 patients (BMI 24–30 kg/m2) with poorly controlled T2DM (HbA1c ≥ 10%) who underwent modified one anastomosis gastric bypass between 2016 and 2017. Primary outcomes included glycemic control, weight loss, and complications at 7 years.

Results

Mean preoperative BMI was 26.76 ± 1.82 kg/m2, and HbA1c was 12.63 ± 1.67%. Follow-up rates were year 1 (54/54, 100%), year 3 (52/54, 96.3%), year 5 (48/54, 88.9%), and year 7 (36/38, 94.7% of eligible patients). At 7-year follow-up, mean HbA1c decreased to 6.17 ± 0.71% (p < 0.001), and %TWL was 13.1 ± 2.4%. Complete medication elimination occurred in 45 of 54 patients (83.3%) achieving HbA1c < 6.5%. No mortality or major complications were reported.

Conclusions

Modified OAGB demonstrates sustained glycemic control and safety in lower-BMI patients with severe T2DM through 7 years with potential benefits of early surgical intervention.