Metabolic Surgery and Class 1 Obesity (< 35 kg/m2): a Prospective Study with Short-, Mid-, and Long-term Results Among Latinos

Introduction Metabolic surgery for managing class 1 obesity and type 2 diabetes mellitus has recently gained popularity. The Latino population presents high rates of these diseases. Reports on surgical outcomes in this population are scarce. Methods Prospective study with Mexican patients diagnosed with diabetes and class 1 obesity submitted to Roux-en-Y gastric bypass. The objective was to determine short-, mid-, and long-term outcomes (weight loss, metabolic, morbidity, and diabetes remission). Sub-analysis was included, based on preoperative usage of one (group A) or more (group B) oral hypoglycemic agents +/- insulin. Results Fifty-one patients with a mean body mass index of 33.1 +/- 1.9 kg/m(2), and glycated hemoglobin 7.2 +/- 1.7% were included. Significant improvements were observed in almost every parameter. At 24, 36, and 60 months, complete diabetes remission was achieved in 73.8%, 52.2%, and 50% of patients with glycated hemoglobin levels of 5.7% +/- 0.8%, 5.8% +/- 0.5%, and 6.1% +/- 0.8%, respectively. At 24, 36, and 60 months, patients in group A (N=28) showed 90.9%, 69.2%, and 75% remission, respectively, versus patients in group B (N=23), who had remission rates of 50%, 30%, and 25% during the same period. Diabetes relapse was higher in patients using >= 2 oral hypoglycemic agents +/- insulin before surgery. Conclusion Gastric bypass is a safe and effective metabolic surgery that results in excellent mid- and long-term results among Mexicans. Patients using one drug preoperatively showed improved results and remission rates, which underscores the importance of intervening in the early stages of the disease.

Automated summary

Metabolic surgery, particularly gastric bypass, has shown to be safe and effective for managing class 1 obesity and type 2 diabetes mellitus in Mexican patients. The study found significant improvements in weight loss, metabolic parameters, morbidity, and diabetes remission post-surgery, especially in patients using only one oral hypoglycemic agent preoperatively. This highlights the importance of early intervention in managing these diseases.