Background

Long-term anti-diabetic effects of BPD in overweight or class 1 obese T2DM patients were investigated reporting the results at ten years after BPD was obtained in non-severely obese T2DM patients. Thirty T2DM patients with BMI lower than 35 kg/m2 were investigated at one, five, and ten years after BPD, and the results of the findings are compared with those of 30 T2DM patients followed for ten years on pharmacological or behavioral conventional therapy. Mean levels of fasting blood glucose (FBG) and serum glycated hemoglobin (HbA1C) showed a marked reduction one year after BPD, values remaining slightly above the diabetic range throughout the entire follow-up. T2DM resolution was observed in about 50% of the cases at 5 and 10 years after the operation. In 16 patients (53%) severe BPD-related complications developed, in ten cases requiring a surgical BPD revision or restoration. Among the BPD group, one patient died for malignant lymphoma and two patients after BPD revisions. Within the control group, during the ten years follow-up, no changes in the diabetic status were observed, being the FBG and HbA1C mean values higher than those recorded in the BPD patients at any follow-up time. All T2DM subjects of the control group were alive at the end of the ten years follow-up. Despite satisfactory long-term metabolic outcomes, these data indicate that BPD should be used with caution as a metabolic procedure in the treatment of T2DM patients with overweight or class 1 obesity.