Aktuelle Ernährungsmedizin 2015; 40 - P3_2
DOI: 10.1055/s-0035-1550206

Improvement in Glucose Metabolism after bariatric surgery: Comparison of Laparoscopic Roux-en-Y Gastric Bypass and Duodenojejunal Bypass

S Guenthert 1, C Stier 2, R Weiner 2, J Stein 1
  • 1Dpt. Gastroenterology and Clinical Nutrition, Hospital Sachsenhausen, Frankfurt, Germany
  • 2Dpt. Obesity Surgery, Sana-Clinics, Offenbach, Germany

Background: Both Roux-en-Y Gastric Bypass (RYGB) and Duodenojejunal Bypass Liner (DJBL) have been shown to induce significant weight loss and dramatically amilorates Typ 2 diabetes mellitus (T2DM). Because DJBL implantation induces nutrient bypass of the duodenum, its mechanisms have been proposed to mimic those of the RYGB. This monocentric prospective parallel group study was aimed to compare both bariatric procedures in the treatment of obesity and T2DM.

Methods: Up to Nov 2014, a total of 37 patients were included. Seventeen (3 male, mean age 50.8 ± 11,8yrs; bw 126.1 ± 21.9 kg; BMI; 45.0 ± 6.8 k g/m2, HbA1c, 7.4 ± 1.0%) received RYGB twenty DJBL (6 male, mean age 52.7 ± 10,8yrs, bw 116.4 ± 28.0 kg; BMI 39.9 ± 7.4 kg/m2; HbA1c, 9.2 ± 1.6%). Body weight (bw), body mass index (BMI), and glycated haemoglobin A1C (HbA1C) were documented 1, 3, and 9 month following each procedure.

Results: Compared to preintervention both procedures resulted in a significant improvement of body weight, BMI and metabolic parameters: RYGB (Δ bw – 28,2 kg; Δ BMI – 10,4 g/m2; Δ HbA1c, -1.1%), DJBL (Δ bw – 22,9 kg; Δ BMI – 8,8 g/m2; Δ HbA1c, -1.4%)

Conclusion: This is the first study comparing the improvement in glucose metabolism following RYGB or DJBL. As expected our preliminary data demonstrated RYGB to be superior by inducing weight loss. However, both procedures have a similar impact on diabetes remission, indicating that alteration of weight loss itself is not the main determinant of improvement in glucose homeostasis in these obesity procedures.