Metabolic Surgery. Abul Fazal Ali Khan Professor of Surgery Allama Iqbal Medical College Lahore. Dr. Abul Fazal Ali Khan Professor of Surgery Allama Iqbal Medical College Lahore. Who would have thought it? An operation proves to be the most effective therapy for T2DM. Background.
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Abul Fazal Ali Khan
Professor of Surgery
Allama Iqbal Medical College Lahore
Who would have thought it?An operation proves to be the most effective therapy for T2DM
> 35” women
< 50 mg/dl women
Treatment of metabolic derangements
with alterations of the gut anatomy.
There is now good evidence that while good Med Treatment does benefit :
There are associated problems like:
Surgery is more effective than MT in treating T2DM
83% of type 2 diabetic subjects euglycaemic
Pories WJ, Swanson MS, MacDonald KG, et al
Annals of Surgery
Many -although not all - patients with type 2 diabetes are able to reduce or stop their diabetes medication after surgery
Consider surgery (RYGBS, LAGB, BPD) as a non-primary alternative for inadequately controlled T2DM with BMI 30-35 kg/m2Rubino et al. Annals of Surgery, 2009
Lap RYGBS for BMI 35:A tailored approach Ricardo Cohen, M.D.*, Jose S. Pinheiro, M.D., Jose L. Correa, M.D.,Carlos A. Schiavon, M.D. Surgery for Obesity and Related Diseases 2 (2006) 401–404
MS can effectively prevent progression from impaired glucose tolerance to diabetes in severely obese individuals
Sjostrom L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. NEnglJMed. 2004;351:2683-93.
Risk of PE
Age≥45yObesity Surgery-Mortality Risk Score
DeMaria et al. SOARD 2007
DeMaria et al. Ann Surg 2007
normal fasting glucose