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Ahmad Nezhadrahim , Matin Moallem Shahri , Nosrati Negarin Akbari

Abstract

Obesity is one of the major issues in the health of the population worldwide. Roux-en-Y gastric bypass (RYGB) is considered a safe and effective treatment in obese patients. In addition RYGB has shown therapeutic potential in type 2 diabetic patients. This study represents a 6 months follow-up on 63 obese patients with BMI≥40 Kg/m³, suffering from both DM2 and CKD, who underwent LRYGB. From 900 obese patients referred to Imam Reza, Sina, and Bentolhoda Hospitals of Mashhad University of Medical Sciences in 2019, 63 were selected for LRYGB. The patient’s diabetic status evaluation 180 days post-surgery revealed that, from 30 patients who used insulin injection before RYGB, 20 (66.6%) achieved full remission, 9 (30%) showed improvement and 1 (3.3%) showed no change in their diabetic state. From 22 patients who received concomitant oral and insulin therapeutic regimens, 11 (50%) achieved full remission, while 9 (40.9%) showed improvement and 2 (9.1%) showed no change in their status. All the patients who received oral medications for DM treatment achieved full remission post-surgery. Duration of obesity was not correlated with either ∆HbA_1c or ∆GFR, however, duration of T2DM showed a significant correlation with ∆HbA_1c (P-value≤0.05). No correlation between T2DM duration and ∆GFR was observed. In conclusion, RYGB is considered a promising approach for T2DM treatment and CKD in obese patients with BMI≥40 Kg/m^3, and its therapeutic effects are due to metabolic alterations rather than weight reduction alone. However, technical considerations in AL and BL lengths for achieving optimal results are under debate‎.

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