The Long-Term Effects of Extensive Gastric Bypass Surgery on Glucose and Lipid Levels

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Specific effects of biliopancreatic diversion on the major components of metabolic syndrome: a long-term follow-up study, by N. Scopinaro and colleagues. Diabetes Care 28:2406–2411, 2005.

What is the problem and what is known about it so far?

Biliopancreatic diversion, also known as the Scopinaro procedure, is a type of weight loss surgery. The procedure involves taking out about two-thirds of the stomach and rearranging the intestines so that digestive enzymes have less contact with the food stream. The Scopinaro procedure is known to result in high weight loss and to improve levels of glucose, triglycerides (a fat-like substance found in the blood), and cholesterol (a waxy, fat-like substance that builds inside tissues). However, there aren't any studies that have looked at the long-term effects of the procedure in a large group of patients.

Why did the researchers do this particular study?

To examine the long-term effects of the Scopinaro procedure among a large group of patients. The researchers wanted to look at how the procedure affected glucose, triglyceride, and cholesterol levels over a long period of time.

Who was studied?

A total of 312 obese patients with type 2 diabetes who underwent the Scopinaro procedure between June 1984 and January 1993.

How was the study done?

The researchers looked at the medical files of the 312 patients and noted their glucose, triglyceride, and cholesterol levels, as well as blood pressure, before the surgery and after the surgery, for up to 10 years after the surgery.

What did the researchers find?

After the surgery, the fasting glucose levels fell within the normal range in all but two of the patients, and remained in the normal range in all but six of the patients up to 10 years after the surgery.

All patients who had unhealthy triglyceride and cholesterol levels before the surgery were able to achieve and maintain healthy levels after the surgery.

Most patients who had high blood pressure before the surgery were able to lower their blood pressure to a normal level after the surgery.

What were the limitations of the study?

This study did not include a "control" group of patients who did not have this type of weight loss surgery.

This study did not address side effects and complications of weight loss surgery, such as acid reflux and nutritional problems.

What are the implications of the study?

According to Scopinaro and colleagues, the Scopinaro procedure is a type of weight loss surgery that results in healthy glucose, triglyceride, cholesterol, and blood pressure levels over a long period of time.

FOR MORE INFORMATION

Surgery to treat obesity. Forefront, Summer/Fall 2005, p. 23. (PDF)

Losing Weight: What Does It Take?

101 Weight Loss Tips for Preventing and Controlling Diabetes, by Anne Daly, Linda M. Delahanty, and Judith Wylie-Rosett (Alexandria, Va., ADA, 2002).