Gastroplastia como tratamento do diabete melito tipo 2

Abstract

-Background -Diabetes mellitus type 2 is not infrequently associated with obesity and can be prevented, improved and even reversed with the different types of bariatric operations. Aim -To compare serum glucose levels on pre and postoperative periods in patients undergoing gastroplasty with Capella and gastric sleeve techniques. Method -A descriptive and prospective analysis of serum glucose levels was done on pre and post-operative patients undergoing these operations. Results -Of the 83 patients analyzed, 76 (91.5%) were female. Ages ranged from 21 to 64 years, with average age of 44 years. Seventy-seven (92.7%) underwent gastroplasty (Capella) and six (7.3%) to gastric sleeve. The pre-operative blood glucose ranged from 125 to 500 mg / dL and dropped to 76 to 120 mg / dL in the post-operative period of three months. Of the 77 patients taking medication for diabetes, 57 had metformin 850 to 3500 mg daily, 18 glibenclamide 5 to 10 mg per day and 17 insulin. After three months of operation, 92.2% stopped using drugs for diabetes and 100% of those who remained medicated decreased from more than 65% the dose of the drug, and none remained dependent of insulin treatment. Conclusion -Bariatric surgery is effective method to improve and even reverse type 2 diabetes mellitus. ABCDDV/814RESUMO -Racional -O diabete melito tipo 2 está, com certa frequência, associado à obesidade mórbida e pode ser prevenido, melhorado e até mesmo revertido com as diversas modalidades de operações bariátricas. Objetivos -Comparar as glicemias séricas pré e pós-operatórias dos pacientes submetidos à gastroplastia com as técnicas de Capella e sleeve gástrico. Método -Estudo descritivo e prospectivo com análises das glicemias séricas pré e pós-operatórias de pacientes submetidos à gastroplastia. Resultados -Dos 83 pacientes analisados, 76 (91,5%) eram do sexo feminino. A idade variou de 21 a 64 anos, sendo 44 anos a idade média. Setenta e sete (92,7%) foram submetidos à gastroplastia (Capella) e seis (7,3%) à sleeve gástrico. A glicemia pré-operatória variou de 125 a 500 mg/dL caindo para a variação de 76 a 120 mg/dL no pós-operatório de três meses. Dos 77 pacientes que usavam tratamento medicamentoso para a diabete, 57 tomavam metformina de 850 a 3500 mg por dia, 18 glibenclamida de 5 a 10 mg por dia e 17 insulina. Após 3 meses da operação, 92,2% cessaram o uso de medicamentos para diabete e em 100% dos que permaneceram medicados houve redução de mais de 65% na dose do fármaco, sendo que nenhum permaneceu dependente de insulina no tratamento. Conclusão -A cirurgia bariátrica constitui-se em método eficaz para a melhora e até mesmo reversão do diabete melito tipo 2.

Relação entre o estado nutricional de vitamina a e a regressão da esteatose hepática após gastroplastia em Y- de- Roux para tratamento da obesidade classe III

“…In a study with 1022 Korean trying to correlate metabolic syndrome with the severity of hepatic steatosis (graded through sonographic criteria), it was found that as the degree of steatosis increased, there was a raise in weight, IR (measured by HOMA), serum levels of liver enzymes and also in serum cholesterol and triglycerides 22 . According to some studies evaluating the epidemiology of NAFLD, this condition is more common in men and its incidence increases with age 3,23 . This fact is consistent with the finding of our analysis where the predominance of females was higher in the group 2 (11/14).…”

“…The vitamin A deficiency may be present in individuals with NAFLD, contributing to the disease, since these individuals are more susceptible to oxidative stress which, by itself, greatly increases the consumption of substances having antioxidant function 27 . Observing the results and efficiency of surgical treatment of class III obesity to reduce the complications of this disease 3,6 , including hepatic steatosis 23 , it was proposed to evaluate the relationship between nutritional status of vitamin A, by serum retinol and β-carotene, and the regression of hepatic steatosis in patients undergoing Rouxen-Y gastric bypass in (RYGB) for the treatment of class III obesity.…”