Efeito do bypass gastrointestinal em y de roux no controle metabólico de pacientes diabéticos tipo 2, candidatos ao transplante de pâncreas após rim

Abstract

Metabolic Surgery for the treatment of type 2 Diabetes Mellitus (T2DM) in patients not morbidly obese (BMI <35 kg/m2) has been widely studied. Taking into account that approximately 12% of pancreas transplants are performed in T2DM patients, we tought to evaluate the impact of the metabolic surgery in the management of obese T2DM on the waiting lists for pancreas transplant. We performed a Roux-en-Y gastrointestinal bypass in 5 insulin-dependent T2DM patients, candidates for pancreas after kidney transplant, with BMI <35 kg/m2. Three patients became insulin independent by the end of the first year while the other two have reduced insulin requirements by 70%. Furthermore, all patients achieved improved control on lipids levels. We conclude the surgery is effective in controlling blood glucose and lipids metabolism in obese T2DM kidney transplant recipients. In this population, a pancreas transplant, along with its associated morbidity, may be avoided.