Long-term Remission of Type 2 Diabetes and Patient Survival After Biliopancreatic Diversion with Duodenal Switch

This study investigates the long-term effects of biliopancreatic diversion with duodenal switch (BPD-DS) on patients with advanced type 2 diabetes mellitus (T2DM) while paying special attention to preoperative diabetes severity.A retrospective analysis was conducted using prospective and current data on patients who underwent an open BPD-DS 6-12 years ago. Patients were stratified according to preoperative diabetes severity into 4 groups (group 1: oral antidiabetic drugs only; group 2: insulin 5 years; group 3: insulin 5-10 years; group 4: insulin 10 years). The primary endpoint was T2DM remission rate 6-12 years after BPD-DS as a function of preoperative diabetes severity.Ninety-one patients with advanced T2DM were included. Sixty-two patients were available for follow-up (rate of 77%). Follow-up was performed (mean ± SD) 8.9 ± 1.3 years after surgery. Glycated hemoglobin (HbABPD-DS causes a rapid and long-lasting normalization of glycemic metabolism in patients with advanced T2DM. T2DM remission rate after 6-12 years varies significantly (from 40% to more than 90%) and is highly dependent on preoperative diabetes severity.