EFFICACY OF DUODENAL SWITCH OPERATION IN THE MANAGEMENT OF DIABETES IN MORBIDLY OBESE PATIENTS

Background: Loop duodenal switch with sleeve gastrectomy is reported to be associated with accepted rates of diabetes remission in obese patients suffering from type II diabetes. We conducted this study to assess the metabolic outcomes of this operation on obese diabetic patients. Study type: Prospective longitudinal cohort study. Patients and methods: Twenty-five cases were included in the study with mean BMI of 61.15 kg/m2. All cases underwent open loop duodenal switch with sleeve gastrectomy. Patients were followed for up after operation for diabetic and metabolic changes. Results: The mean age of the included cases was 34.16 years. Patient weight and BMI were significantly decreased at follow up (p < 0.001). Lipid profile showed a marvelous improvement compared to baseline levels preoperatively. Blood glucose and HbA1c levels were significantly improved (p < 0.001). No significant changes were detected regarding bilirubin or calcium levels. Diabetes full remission was detected in 12 cases (48%) and 8 cases (32%) at 1 and 2 years respectively whereas diabetic control was found 4 cases (16%) at the previously mentioned follow up visits. Regarding complications, GERD was detected in 2 cases (8%) while leakage and intestinal obstruction were detected in one case (4%) for each complication. Conclusion: Based on the results of our study, it is evident that loop duodenal switch with sleeve gastrectomy is effective surgical method in the management of diabetes in obese individuals with accepted morbidity and mortality rates.