2型糖尿病可在减肥手术后逆转

2型糖尿病可在减肥手术后逆转
Type 2 diabetes often reverses after modified weight loss surgery, especially when the duration of diabetes is less than 10 years, a new study finds. The results will be presented Tuesday at The Endocrine Society's 94th Annual Meeting in Houston.

一项新的研究发现：II型糖尿病可在减肥手术后逆转，尤其是病程不足10年的II型糖尿病。此项研究结果将于周二在休斯敦举行的内分泌协会第94届年会中公布。

"Modified bariatric surgery such as sleeve gastrectomy should be considered at an earlier stage of Type 2 diabetes, rather than as a last resort," said the senior investigator, Kirtikumar Modi, MD, an endocrinologist at Medwin Hospital, Hyderabad, India.

印度海德拉巴市Medwin医院内分泌医师，资深研究员，Kirtikumar Modi博士讲道：“在II型糖尿病早期，应考虑改进的减肥手术（如胃切除术），而不是将减肥手术作为最后的解决办法。”


Sleeve gastrectomy is a less radical form of restrictive weight loss surgery than gastric bypass, the most common type of bariatric surgery. It reduces the size of the stomach using laparoscopic ("keyhole") surgery and stomach stapling. Recent research shows that the procedure can resolve or greatly improve Type 2 diabetes in obese patients and even in some diabetic patients who are not obese.

相对于常见减肥手术-胃分流术而言，胃切除术并非很极端的减肥手术。该手术通过腹腔镜（“锁孔”）手术和胃部缝折减少胃内容量。此举可治愈或大大改善肥胖型患者的II型糖尿病，非肥胖型的II型糖尿病患者也适用。


Initially, Modi and co-workers studied 43 patients with Type 2 diabetes who had sleeve gastrectomy with ileal interposition, in which the ileum, a part of the small intestine, is moved closer to the stomach. All patients had poorly controlled diabetes, with an average disease duration of 10 years. On average, their body mass index (BMI) was 33 kg/m2.

最初，Modi和同事对接受回肠干预胃切除术的43例II型糖尿病患者开展研究。回肠干预胃切除术，是将回肠（即小肠的一部分）移近胃部。研究纳入的所有糖尿病患者，其疾病控制不佳且平均病程为10年，平均体重指数（BMI）33kg/m2。

After sleeve gastrectomy, 20 (47 percent) of the patients no longer had diabetes, at an average follow-up of 20 months, the authors reported. Remission of diabetes was defined as having a hemoglobin A1c level (a measure of blood sugar control over the past three months) below 6.5 percent and no longer needing insulin or oral hypoglycemic agents (blood sugar-lowering medications). The other 23 patients in this group all needed fewer or smaller doses of oral diabetes medications, Modi said. Of the 30 patients who had high blood pressure before surgery, 27 (90 percent) no longer had hypertension after the operation, according to the study abstract.

作者称：在随访的20个月里，经胃切除术的22例（47%）患者糖尿病病症消失。治愈糖尿病的定义为，糖化血红蛋白水平（连续3个月的血糖控制措施）低于6.5且不再使用胰岛素或口服降糖药物。其他23例患者降糖制剂或口服降糖药物用量降低，Modi讲道。研究摘要显示，手术前有30例患者有高血压病症，术后有27例（90%）高血压病症消失。

Patients who had better improvement in diabetes remission and other metabolic abnormalities were those who had diabetes less than 10 years and a BMI above 27, the researchers found. When they excluded nonobese patients from analysis, the diabetes remission rate increased to 85 percent, similar to that reported with gastric bypass surgery, Modi said.

研究人员发现：那些糖尿病病症及其他代谢异常得到明显缓解的患者，其糖尿病病程不足10年且BMI超过27。Modi表示：经分析排除非肥胖型糖尿病患者，肥胖型糖尿病患者的糖尿病缓解率增至85%，胃分流术也有类似报道。

Based on these predictors of good outcomes, the researchers assigned 17 additional patients with Type 2 diabetes to undergo a different modification of bariatric surgery, called diverted sleeve gastrectomy. This laparoscopic procedure diverts food away from parts of the small intestine, including the duodenum, where absorption of nutrients begins. The patients received this procedure because, compared with the original group, they had a longer duration of diabetes-15 years on average-and a lower BMI (29 kg/m2), which predicted worse outcomes with sleeve gastrectomy, Modi explained.

基于对良好试验结果的预测，研究人员另分配17例II型糖尿病患者接受另一减肥手术-胃分流术。这种腹腔镜手术可使食物远离小肠，包括开始吸收营养的十二指肠。Modi解释称：与上组患者相比，这些糖尿病患者平均病程长达15年且体重指数较低（29kg/m2），对其实施胃切除术预后较差，因此开展胃分流术。

An average of nine months after diverted sleeve gastrectomy, 12 patients, or more than 70 percent, had remission of diabetes. The investigators reported that the remaining five patients had decreased requirements for oral hypoglycemic medications. Seven of the eight patients (nearly 88 percent) who had high blood pressure before surgery no longer did postoperatively.

实施胃分流术后9个月，有12例或超过70%患者糖尿病病症平均得到缓解。研究人员报道，其他5例患者口服降糖药物用量降低。其中8例高血压患者中有7例（约88%）高血压病症消失。

"Modified bariatric surgery promises to be an effective treatment for achieving a cure of Type 2 diabetes and other metabolic abnormalities like high blood pressure," Modi said.

Modi说：“改进的减肥手术可有效治愈糖尿病及其他代谢异常疾病（如高血压）”。

学习糖尿病
还是中英文哦