The constantly growing incidence of obesity represents a risk of health complications for individuals, and is a growing economic burden for health care systems and society. The aim of this study was to evaluate the efficacy of bariatric surgery, specifically laparoscopic greater curve plication, laparoscopic sleeve gastrectomy, and Roux-en-Y gastric bypass, in patients with type 2 diabetes mellitus. The effect of bariatric surgery on the changes in blood pressure before, and 12 months after, surgery and in pharmacotherapy in the 12 months after surgery was analyzed. For achieving this purpose, 74 patients from the Obesity and Surgery Department of Vitkovice Hospital in Ostrava in the Czech Republic, were monitored. They were operated in 2011 and 2012. The Bonferroni method was used to test hypotheses about the impact of surgery on blood pressure and pharmacotherapy. One year after the surgery, systolic and diastolic blood pressure values decreased, both with no statistically significant difference between surgery types. Improvement was observed in 68% of cases, with 25% of patients discontinuing pharmacotherapy entirely.

Faculty of Informatics and Management University of Hradec Kralove Hradec Kralove Czech Republic

Faculty of Informatics and Management University of Hradec Kralove Hradec Kralove Czech Republic; Biomedical Research Center University Hospital Hradec Kralove Hradec Kralove Czech Republic

Research Obesity Center Faculty of Medicine University of Ostrava Ostrava Czech Republic

Zobrazit více v PubMed

Dobbs R, Sawers C, Thompson F, et al. How the world could better fight obesity [Internet] [Accessed June 6, 2015]. (Report of the McKinsey Global Institute). Available from: http://www.mckinsey.com/insights/economic_studies/how_the_world_could_better_fight_obesity.

Maglione MA, Gibbons MM, Livhits M, et al. Bariatric Surgery And Nonsurgical Therapy in Adults with Metabolic Conditions And A Body Mass Index of 30.0 to 34.9 Kg/m2. Rockville, MD: Agency for Healthcare Research and Quality; 2013. [Accessed June 20, 2015]. (Comparative Effectiveness Review 82 [AHRQ Publication No. 12(13)-EHC139-EF]). Available from: http://www.effectivehealthcare.ahrq.gov/ehc/products/227/1482/weight-loss-surgery-report-130529.pdf. PubMed

Fried M, Hainer V, Basdevant A, et al. Interdisciplinary European guidelines on surgery of severe obesity. Obes Facts. 2008;1:52–59. PubMed PMC

Kenngott HG, Clemens G, Gondan M, et al. DiaSurg 2 trial – surgical vs. medical treatment of insulin-dependent type 2 diabetes mellitus in patients with a body mass index between 26 and 35 kg/m2: study protocol of a randomized controlled multicenter trial – DRKS00004550. Trials. 2013;14:183. PubMed PMC

Meisinger C, Döring A, Thorand B, Heier M, Löwel H. Body fat distribution and risk of type 2 diabetes in the general population: are there differences between men and women? The MONICA/KORA Augsburg cohort study. Am J Clin Nutr. 2006;84(3):483–489. PubMed

Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg. 2014;24(1):42–55. PubMed

Fischer L, Wekerle AL, Bruckner T, et al. BariSurg trial: sleeve gastrectomy versus Roux-en-Y gastric bypass in obese patients with BMI 35–60 kg/m2 – A multi-centre randomized patient and observer blind non-inferiority trial. BMC Surg. 2015;15:87. PubMed PMC

Fischer L, Hildebrandt C, Bruckner T, et al. Excessive weight loss after sleeve gastrectomy: a systematic review. Obes Surg. 2012;22(5):721–731. PubMed

Anděl J. Fundamentals of Mathematical Statistics. Prague, Czech Republic: Matfy-Zpress; 2005.

The Czech Diabetes Society (CDS) Homepage of The Czech Diabetes Society. [Accessed June 6, 2015]. Available from: http://www.diab.cz/

Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–1737. PubMed

Sugerman HJ, Starkey JV, Birkenhauer R. A randomized prospective trial of gastric bypass versus vertical banded gastroplasty for morbid obesity and their effects on sweets versus non-sweets eaters. Ann Surg. 1987;205(6):613–624. PubMed PMC

DePaula AL, Stival AR, Halpern A, Vencio S. Surgical treatment of morbid obesity: mid-term outcomes of the laparoscopic ileal interposition associated to a sleeve gastrectomy in 120 patients. Obes Surg. 2011;21(5):668–675. PubMed

Czech Diabetes Society Doporučeny postup peče o diabetes mellitus 2. Typu. [Recommended process of care for type 2 diabetes mellitus] [Accessed June 20, 2015]. Available from: http://www.diab.cz/dokumenty/dm2_12.pdf. Czech.

Svačina Š. Diabetes, bariatric surgery: a practical guide to the pros and cons. Postgrad Med. 2012;14:39–41.

Matoulek M, Svačina Š, Lajka J. Výskyt obezity a jejích komplikací v České republice [The incidence of obesity and its complications in the Czech Republic] Vnitřní lékařství. 2010;56(10):1019–1027. Czech. PubMed

Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–1576. PubMed PMC

Boza C, Valderas P, Daroch DA, et al. Metabolic surgery: Roux-en-Y gastric bypass and variables associated with diabetes remission in patients with BMI <35. Obes Surg. 2014;24(8):1391–1397. PubMed

Vidal JA, Ibarzabal F, Romero S, et al. Type 2 diabetes mellitus and the metabolic syndrome following sleeve gastrectomy in severely obese subjects. Obes Surg. 2008;18(9):1077–1082. PubMed

Zimmet P, Alberti KG. Surgery or medical therapy for obese patients with type 2 diabetes? N Engl J Med. 2012;366(17):1635–1636. PubMed

Peterli R, Wölnerhanssen B, Peters T, et al. Improvement in glucose metabolism after bariatric surgery comparison of laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy a prospective randomized trial. Ann Surg. 2009;250(2):234–241. PubMed

Mingrone G, Castagneto-Gissey L. Mechanisms of early improvement/resolution of type 2 diabetes after bariatric surgery. Diabetes Metab. 2009;35(6 Pt 2):518–523. PubMed

Fried M, Ribaric G, Buchwald JN, Svacina S, Dolezalova K, Scopinaro N. Metabolic surgery for the treatment of type 2 diabetes in patients with BMI 35 kg/m2: an integrative review of early studies. Obes Surg. 2010;20(6):776–790. PubMed