Endocrine Abstracts (2009) 19 P117

Ileal switch with sleeve gastrectomy for control of type 2 diabetes

KD Modi1, KVS Hari Kumar1, Suren Ugale2, Vishwas Naik2 & Neeraj Gupta2

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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