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首页> 外文期刊>ANZ journal of surgery >Efficacy of surgery in the management of obesity-related type 2 diabetes mellitus.
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Efficacy of surgery in the management of obesity-related type 2 diabetes mellitus.

机译：手术治疗肥胖相关的2型糖尿病的功效。

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BACKGROUND: It is estimated that up to 80% of persons with diabetes mellitus type 2 are overweight and in these patients it is recognized that effective weight control can lead to improvement or even resolution of their diabetes (Colagiuri et al.). All currently carried out operations for morbid obesity have been shown to improve diabetes, but there appears to be a variable response to surgery depending on several surgical and patient factors. METHODS: In this prospective review, we analysed the change in the diabetic status in 72 patients undergoing three different bariatric procedures in a single institution over 30 months. A review of the published work comparing the efficacy of the various procedures in achieving improvement or resolution of diabetes was also carried out and correlated to our findings. RESULTS: At an average follow up of 13 months, 50% of patients who had placement of laparoscopic adjustable gastric band had an improvement or resolution of their diabetes, compared with 95% of patients who had had laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass. Two of 12 (17%) laparoscopic adjustable gastric band patients had normal blood glucose levels off all diabetic medications compared with 7 of 21 (33%) laparoscopic sleeve gastrectomy and 27 of 39 (69%) Roux-en-Y gastric bypass patients. There was no significant association between the amount of weight lost and the return to euglycaemia. CONCLUSION: Direct comparison has shown a significant difference in the effects of different forms of bariatric surgery on type 2 diabetes, this is in keeping with evidence that surgery can lead to improvement in diabetes additional to that obtained by weight loss alone.
机译：背景：据估计，多达80％的2型糖尿病患者超重，在这些患者中，有效的体重控制可导致其糖尿病的改善甚至消退（Colagiuri等）。已经显示，目前对病态肥胖症进行的所有手术均可改善糖尿病，但根据几种手术和患者因素，对手术的反应似乎不同。方法：在这项前瞻性综述中，我们分析了在30个月内在一家机构中接受三种不同减肥手术的72名患者的糖尿病状况变化。还对已发表的研究进行了比较，比较了各种方法在改善或解决糖尿病方面的功效，并将其与我们的发现相关联。结果：平均随访13个月，放置腹腔镜可调节胃带的患者中50％的患者糖尿病得到改善或消退，而接受腹腔镜袖胃切除术或Roux-en-Y的患者为95％胃绕道。在所有糖尿病药物中，有12名（17％）腹腔镜可调节胃带患者中有2名血糖水平正常，而21名（33％）腹腔镜袖胃切除术中有7名和39名（69％）Roux-en-Y胃旁路手术患者中有27名。体重减轻与正常血糖恢复之间没有显着关联。结论：直接比较显示了不同形式的减肥手术对2型糖尿病的治疗效果存在显着差异，这与证据表明，除单纯减肥外，手术还可以改善糖尿病。

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