The Long-Term Outcomes of Mini-Gastric Bypass in Patients with Type 2 Diabetes and Morbid Obesity

BACKGROUND: Obesity is considered one of the leading global health issues. According to a meta-analysis published in the Lancet, in 2024 there were 880 million adults and 159 million children with obesity worldwide. Surgical treatment is one of the main methods for managing morbid obesity. There are several options for surgical treatment, but mini-gastric bypass is gaining popularity among bariatric surgeries. The operation is considered effective in reducing body mass and achieving remission of obesity-related comorbidities. The main advantage of this type of surgical intervention is the combination of relative simplicity and safety of the operation compared to other shunting bariatric interventions with sufficient efficacy on the course of type 2 diabetes mellitus. Despite the advantages of this technique, there is limited research published in this area.

AIM: Assess the long-term outcomes of mini-gastric bypass in patients with morbid obesity.

MATERIALS AND METHODS: The study presents the results of a 2-year follow-up of 30 patients who underwent mini-gastric bypass surgery. The patients' average age was 52.5 [50–56.5] years, and their preoperative BMI was 50.0 kg/m2 [46.2–59.6]. Follow-up assessments were conducted at 6, 12, 18, and 24 months over a two-year period post-surgery. During the observation period, anthropometric data (BMI, waist circumference, hip circumference, excess weight loss percentage — EWL, total weight loss percentage — TWL), fasting blood glucose level, glycated hemoglobin (HbA1c), and postoperative adverse events were evaluated. RESULTS: After two years post-surgery, the median BMI value was 33.6 kg/m2 [28.4–36.5] (p<0.001) with an excess weight loss of 33.6% [28.4–36.4] (p<0.001). The greatest excess weight loss of 35.6% [26.6–54.2] (p<0.001) and 56.0% [39.0–56.0] (p<0.001) was observed at 6 and 12 months of the study, respectively. Similar results were also noted for other parameters. During the study period, remission of type 2 diabetes was achieved in 40% of patients (n=12) at 12 months of observation and in 80% of patients (n=24) at 24 months of observation. A significant reduction in adverse events was observed in the second year of the study compared to the first year.

CONCLUSION: Therefore, mini-gastric bypass surgery is an effective bariatric procedure that leads to weight loss and remission of type 2 diabetes.

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