Biliopancreatic Diversion: The Effectiveness of Duodenal Switch and Its Limitations

Table 1

Effect of biliopancreatic diversion with duodenal switch on diabetes.

Study; 𝑛 (number of patients)	DM incidence preoperatively	Resolution of DM	Measure of resolution
Buchwald et al. [17]; 31 studies of BPD; 𝑛=2502	30%	95%	Clinical and laboratory manifestations of diabetes—not otherwise specified (different measures for individual studies)
Biertho et al. [21]; 𝑛=810	28%	93%	Discontinuation of diabetic treatment (oral hypoglycemic agents/insulin)
Crea et al. [24]; 𝑛=540			Discontinuation of diabetic treatment (oral hypoglycemic agents/insulin) within 1 yr
A-BPD: 287	A-35%	A-98%
B-DS: 253	B-36%	B-64%
Papadia et al. [25]; 𝑛=68	3%	100%	Fasting glucose < 125 mg/dL
Mingrone et al. [30]; 𝑛=60			Discontinuation of diabetic treatment (oral hypoglycemic agents/insulin), fasting glucose < 100 mg/dL, and HbA1C < 6.5%
A-medical: 20	A-100%	A-0%
B-RYGB: 20	B-100%	B-75%
C-BPD: 20	C-100%	C-95%
Iaconelli et al. [31]; 𝑛=50			Not defined
A-medical: 28	A-100%	A-45%
B-BPD: 22	B-100%	B-100%
Tsoli et al. [32]; 𝑛=24			Oral glucose tolerance test
A-BPD: 12	A-100%	A-100%
B-SG: 12	B-100%	B-100%
Astiarraga et al. [33]; 𝑛=30	50%	40%	HbA1C < 6.5% and normal oral glucose tolerance test
Marceau et al. [34]; 𝑛=1423	28%	92%	Discontinuation of oral hypoglycemic agents; Discontinuation of insulin
		98%
Vage et al. [35]; 𝑛=80	100%	94%	Fasting glucose < 7 mmol/L and HbA1C < 6.5%
Dorman et al. [36]; 𝑛=329			Self-reported
A-BPD/DS: 173	A-36%	A-82%
B-RYGB: 139	B-31%	B-64%
Prachand et al. [37]; 𝑛=350			Discontinuation of the medications used for treatment with the absence of symptoms
A-BPD/DS: 198	A-24%	100%
B-RYGB: 152	B-36%	60%
Pata et al. [38]; 𝑛=874	35%	97%	Discontinuation of oral hypoglycemic agents; Discontinuation of insulin
		67%

DM: diabetes mellitus.
BPD: biliopancreatic diversion.
DS: duodenal switch.
RYGB: Roux-en-Y gastric bypass.
SG: sleeve gastrectomy.