Searchable abstracts of presentations at key conferences in endocrinology
Endocrine Abstracts (2009) 19 P117

SFEBES2009 Poster Presentations Diabetes, Metabolism and Cardiovascular (49 abstracts)

Ileal switch with sleeve gastrectomy for control of type 2 diabetes

KD Modi 1 , KVS Hari Kumar 1 , Suren Ugale 2 , Vishwas Naik 2 & Neeraj Gupta 2

1Medwin Hospitals, Hyderabad, India; 2Kirloskar Hospitals, Hyderabad, India.

Introduction: Recent reports suggest that bariatric procedures are effective for control or cure of type 2 diabetes. We plan to study the efficacy of a novel surgical procedure on glycemic control and other constituents of metabolic syndrome in type 2 diabetes patients.

Methods: In this ongoing study, five patients underwent laparoscopic procedure of ileal switch (transposition of a segment of ileum into proximal jejunum) coupled with sleeve gastrectomy. All patients had diagnosis of diabetes for more than 3 years with poor control despite use of oral hypoglycemic agents (OHA) and insulin. The primary outcome is remission of diabetes (HbA1c<7% without requiring OHA) and secondary outcomes are change in weight, blood pressure, insulin resistance and in parameters of metabolic syndrome.

Results: Out of 5 patients who underwent surgery, we report the 6 month follow up data of two patients, and 2 month follow up of another 2 patients. The first two patients had remission in diabetes and other two showed significant decrease in requirement of OHA. HbA1c dropped from 9.9 to 7% in 1st patient and from 15.8 to 5.8% in 2nd patient. All 4 patients showed remission of hypertension (not requiring anti hypertensive drugs) coupled with significant weight loss ranging from 11 to 29%. There was significant improvement in secondary outcomes measured.

Conclusion: Our preliminary data demonstrated the safety and efficacy of this novel surgical procedure in type 2 diabetes. Further long term data from more number of patients is necessary to confirm these findings.

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