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Cited by 2,293Bariatric Surgery and OutcomesMinimally Invasive Surgical TechniquesDiabetes, Cardiovascular Risks, and Lipoproteins

The DOI matches its Crossref record; 18 of the 18 references it cites were found in a registry or an index.

Who Would Have Thought It? An Operation Proves to Be the Most Effective Therapy for Adult-Onset Diabetes Mellitus

Open access
Pories, Walter J., Swanson, Melvin S., MacDonald, Kenneth G., Long, Stuart B., Morris, Patricia G., Brown, Brenda M., Barakat, Hisham A., deRamon, Richard A., Israel, Gay, Dolezal, Jeanette M., Dohm, Lynis·1995·Annals of Surgery
DOI 10.1097/00000658-199509000-00011PMC PMC1234815
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Abstract

OBJECTIVE: This report documents that the gastric bypass operation provides long-term control for obesity and diabetes. SUMMARY BACKGROUND DATA: Obesity and diabetes, both notoriously resistant to medical therapy, continue to be two of our most common and serious diseases. METHODS: Over the last 14 years, 608 morbidly obese patients underwent gastric bypass, an operation that restricts caloric intake by (1) reducing the functional stomach to approximately 30 mL, (2) delaying gastric emptying with a c. 0.8 to 1.0 cm gastric outlet, and (3) excluding foregut with a 40 to 60 cm Roux-en-Y gastrojejunostomy. Even though many of the patients were seriously ill, the operation was performed with a perioperative mortality and complication rate of 1.5% and 8.5%, respectively. Seventeen of the 608 patients (< 3%) were lost to follow-up. RESULTS: Gastric bypass provides durable weight control. Weights fell from a preoperative mean of 304.4 lb (range, 198 to 615 lb) to 192.2 lb (range, 104 to 466) by 1 year and were maintained at 205.4 lb (range, 107 to 512 lb) at 5 years, 206.5 lb (130 to 388 lb) at 10 years, and 204.7 lb (158 to 270 lb) at 14 years. The operation provides long-term control of non-insulin-dependent diabetes mellitus (NIDDM). In those patients with adequate follow-up, 121 of 146 patients (82.9%) with NIDDM and 150 of 152 patients (98.7%) with glucose impairment maintained normal levels of plasma glucose, glycosylated hemoglobin, and insulin. These antidiabetic effects appear to be due primarily to a reduction in caloric intake, suggesting that insulin resistance is a secondary protective effect rather than the initial lesion. In addition to the control of weight and NIDDM, gastric bypass also corrected or alleviated a number of other comorbidities of obesity, including hypertension, sleep apnea, cardiopulmonary failure, arthritis, and infertility. Gastric bypass is now established as an effective and safe therapy for morbid obesity and its associated morbidities. No other therapy has produced such durable and complete control of diabetes mellitus.

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Crossref · 10.1097/00000658-199509000-00011

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Metadata

Authors
Pories, W. J., Swanson, M. S., MacDonald, K. G., Long, S. B., Morris, P. G., Brown, B. M., Barakat, H. A., deRamon, R. A., Israel, G., Dolezal, J. M., & Dohm, L.
Affiliations
East Carolina University (US)
ORCID
Pories, Walter J.
Venue
Annals of Surgery
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
1995-09
Volume
222
Issue
3
Pages
339-352
ISSN
0003-4932 (ISSN-L)
DOI
10.1097/00000658-199509000-00011
PMC
PMC1234815
OpenAlex
W2038034590
Cited by
2,293
References
18
Citations by year
2026: 27 · 2025: 34 · 2024: 37 · 2023: 47 · 2022: 53 · 2021: 56 · 2020: 54 · 2019: 79 · 2018: 70 · 2017: 82 · 2016: 97 · 2015: 119 · 2014: 129 · 2013: 127 · 2012: 139
FWCI
15.09
Type
journal article
Language
en
Open access
Locations
  • Annals of Surgery (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • The Scholarship East Carolina University's Institutional Repository (East Carolina University) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
obesity, adult-onset diabetes mellitus, type 2 diabetes, gastric bypass, bariatric surgery, weight loss, diabetes remission, insulin resistance, Roux-en-Y gastrojejunostomy, obesity-related comorbidities, hypertension, sleep apnea, infertility, long-term outcomes, surgical complications, caloric restriction, HbA1c, insulin requirement
MeSH terms
Adolescent, Adult, Blood Glucose, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Gastric Bypass, Weight Loss

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