Case two: named Mao, female, 62 years old, due to high blood pressure in type 2 diabetes admitted to hospital in May 2007 laparoscopic gastric bypass surgery. Required oral hypoglycemic agents before surgery and blood pressure medicine. She stands 160 cm,mac makeup, weight 67 kg before surgery, BMI = 26 kg / m 2, fasting plasma glucose 8.5mmol / L, postprandial blood glucose 14.3mmol / L, glycosylated hemoglobin 8.5%. Preoperative blood pressure: 140/90 mm Hg. All patients had stopped taking antihypertensive drugs and hypoglycemic agents. 3 months after examination, body weight dropped to 57 kg, BMI = 22 kg / m 2. Fasting plasma glucose 4.8mmol / L, postprandial 6.0mmol / L, glycosylated hemoglobin 5.5%. Blood pressure stabilized at 120/80 mm Hg is currently about. Efficacy Evaluation: cured.
s
conventional treatment of diabetes blood sugar can rarely return to normal, can not avoid the appearance of various complications of diabetes and further increase. However, obesity surgery through clinical observations, weight loss, morbid obesity surgery patients can not only achieve significant and lasting weight loss, but also to improve or solve their concurrent diseases, especially type 2 diabetic patients, especially effective.
weight-loss surgery, including adjustable gastric bandage technique, cuff gastrectomy, gastric bypass,nhl hockey, biliopancreatic bypass and so on. China's weight-loss surgery to the stomach bandage technique based. Gastric surgery works by straps restricted diet and weight loss surgery to treat. Large sample of cases reported after gastric bandage, diabetes, weight loss mitigation and synchronization. 50% of diabetic patients to be cured (ie disable all antidiabetic drugs without dietary restrictions, able to maintain normal blood sugar), the rest of the patient's condition had improved, but mostly in patients cured of early diabetes.
gastric bypass and biliopancreatic bypass surgery referred to as gastrointestinal bypass surgery. Patients usually within one month after gastrointestinal bypass surgery restore normal blood sugar, diabetes, and weight loss mitigation is not synchronized. The original need for the drugs control blood sugar significantly reduced the number and type of withdrawal as well. Most diabetes complications, according to their severity can be relieved and even cured. Depending on the center of the reported cure rate at 84% to 100%. Condition only improved but there is no cure for the common characteristics of patients with a longer history of diabetes or older, these patients may islet dysfunction or failure. So that the function of islet B cell reserve is to determine the effect of surgery one of the factors, the proposed surgical treatment of patients with type 2 diabetes should be early intervention. Experts abroad for surgery and no surgery were compared, and found in the surgical group mortality rate far lower than the conservative treatment group.
after gastrointestinal bypass surgery did not significantly decrease body weight, the blood glucose returned to normal, indicating that after gastrointestinal bypass surgery to improve blood sugar is not only caused by the weight loss and dietary restrictions. Analysis of domestic and foreign scholars think, first of all weight loss significant weight loss surgery will lead to insulin resistance and B cell function in mitigation improved to varying degrees, more importantly, the mechanism is through the gastrointestinal bypass surgery, hormone changes in the gastrointestinal tract to improve sugar metabolism, increase insulin sensitivity, improve the islet B cell function.
bypass surgeries, however, the risk of postoperative malnutrition, for the control of type 2 diabetes, patients need to weigh the long-term follow-up and agree to before making choices. As for medical treatment not satisfied with stubborn disease with diabetes (especially associated with severe obesity of patients),vibram five fingers, surgery is a good choice.
Although surgical treatment of type 2 diabetes mellitus and has only just begun, but has made a large number of domestic and international clinical studies and animal experiments confirmed that such surgery for the morbidly obese non-diabetic patients are also effective. We believe that the basic and clinical work with the deepening, more and more patients would choose surgery to treat type 2 diabetes. Surgery, opened a new chapter for the treatment of diabetes.
Editor's Notes:
This paper describes a new treatment of type 2 diabetes, especially in patients with severe obesity, the method. Editor's view, this article describes 2 cases of patients undergoing this type of diet to achieve significant improvement in diabetes after surgery is possible, mainly due to corrected obesity, insulin resistance was reduced. Although there may be other possible mechanisms for the mitigation of diabetes, but diet and weight loss is the most important part. Editors believe that these patients lose weight using other methods if the real weight reduced to normal, supplemented diet, high blood sugar can also be controlled, hypoglycemic drugs can be reduced or stopped, at least some patients can achieve this goal. Such surgical treatment is weight loss, mitigation and treatment of severe obesity (BMI> 30 kg / m 2) were the good function of insulin secretion in patients with type 2 diabetes a way, but not suited to normal weight or slightly obese patients not adapted to the lifestyle adjustments or by taking a small amount of drugs can be good control of diabetes. The weight loss method in the choice of treatment of diabetes, the doctors and patients need to be careful.
BMI = weight (kg) / height (M2). According to the WHO diagnostic criteria for obesity in Western Asia Pacific region, BMI of the normal value of 18.5 ~ 22.9 kg / m 2,23 ~ 24.9 kg / m 2 for obesity pre-, 25 ~ 29.9 kg / m 2 for obesity 1, ≥ 30 kg / m 2 as obese 2, or severe obesity.
没有评论:
发表评论