Cirugía metabólica en diabéticos tipo 2 obesos. Hospital Teodoro Maldonado Carbo 2016 – 2020.

Abstract

Type 2 diabetes mellitus is a heterogeneous metabolic disease with a geneticenvironmental component in which there is chronic hyperglycemia resulting from an alteration in secretion and resistance to a hormone produced by the beta cells of the pancreas called insulin. If it is not controlled or is not controlled adequately, the persistence of high blood glucose for a significant time causes damage to different target organs. The diagnosis is clinical and laboratory, where glucose and glycosylated hemoglobin tests are requested. Its treatment is pharmacological and a change in lifestyle; however, the fundamental pillar is its prevention through education programs and population screening. Currently, certain surgical procedures have been added to therapeutics, specifically bariatric or metabolic surgeries, especially laparoscopic gastric sleeve and Roux-en-Y gastric bypass, on which this research work is focused, in order to demonstrate that it effectively improves glycemic controls besides the weight. Materials and methods: it is an observational, analytical and longitudinal retrospective study of obese diabetic patients undergoing metabolic surgery between 2016-2020 at Teodoro Maldonado Carbo Hospital. Data collected included age, sex, pre and post surgical antidiabetic drugs requirements, glucose, HbA1c, cholesterol, HDL, LDL, triglycerides and BMI previous and after the surgery. Results: The study population obtained was 58 patients. There was an improvement in the biochemical parameters. The results show that the majority of patients who underwent metabolic surgery are between 46 and 55 years old. More than 85% decreased their blood glucose at one month and at 3 months. The total of the patients reduced their weight and BMI. Conclusion: There was an improvement in the different biochemical parameters, both in glycemia and glycosylated hemoglobin as well as in the lipid and nutritional profile. Therefore, based on this study, metabolic surgery is a valid option for obese diabetics who meet the criteria for surgery. However, it is recommended to read more studies and compare it with this one due to the small population obtained and incomplete data such as a registry of glycosylated hemoglobin of all patients that could not be obtained because not all of them were asked this exam, a parameter that would have been more reliable and useful to assess pre- and post-surgical glycemic control.