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Dănuț Dejeu, Viorel Dejeu and Aurel Babeș

Abstract

Background and Aims. We aimed to analyze the complications and mortality of acute abdomen cases in diabetic patients compared to non-diabetic patients. Materials and Method. This observational, retrospective, cohort study was conducted between 2008 - 2011, on a total of 4021 cases with acute abdomen admitted to the Surgical Ward I of the Clinical County Emergency Hospital Oradea. Of these, 488 were diabetic patients and 3533 non-diabetics. Results. Women represented the majority in both groups (62.24% respectively 58.40%). Entero-mesenteric infarction and acute pancreatitis were more common in diabetic patients compared to non-diabetics. Peritonitis was more frequent in non-diabetics, with statistically significant difference (p = 0.0003). In diabetic patients the postoperative morbidity was 36.27%, significantly higher than in non-diabetic patients (14.43%). The mortality was significantly higher in diabetic patients than in nondiabetics (9.84% vs. 5.38%). Average length of stay in Surgical Ward I is 3.8 days. For non-diabetic patients, mean hospitalization for acute abdomen was 5.1 days, and for diabetics 7.8 days. Conclusions. This study showed important differences between diabetics and non-diabetic patients in the clinical evolution, complications, mortality and length of hospitalization.

Open access

Viorel Dejeu, Dănuţ-Aurel Dejeu, Paula Dejeu and Aurel Babeş

Abstract

Background and aims: Bariatric surgery has been shown to be superior to nonsurgical approaches in terms of weight loss and remission of type 2 diabetes (T2DM) and metabolic syndrome. This prospective, single-center, follow-up study assessed percentage of excessive weight loss (%EWL), glycosylated hemoglobin (HbA1c) levels, prescribed antidiabetes drugs and diabetes remission rates in obese T2DM patients who underwent laparoscopic sleeve gastrectomy.

Materials and methods: 81 patients were selected and data recorded preoperatively, 3, 6 and 12 months postoperatively.

Results: We recorded - 69.3% EWL at 12 months (p<0.0001 compared to baseline) and a fall of HbA1c from 8.1±2.6% to 6.7±2.8% at 12 months postoperatively (p<0.0001). The percentage of patients with HbA1c<6.5% showed an increase to 40.7% (p=0.0004) and the one year T2DM remission rate was 20.9% (p=0.0012).

Conclusions: Laparoscopic sleeve gastrectomy can significantly reduce the BMI, with near 70% EWL and near 21% T2DM remission rate in 1 year.

Open access

Paula Dejeu, Viorel Dejeu, Dănuț Dejeu and Bembea Marius

Abstract

Background and aims: Overweight and obese individuals are prone to an insulin resistance status assessed in the present study by the HOMA index ("Homeostasis model assessment"). This prospective study assessed the body mass index (BMI) and the insulin resistance status (HOMA index) in obese patients after bariatric surgery (gastric sleeve, gastric by-pass).

Material and Methods: The study included 48 patients who were assessed before the bariatric surgery and at 6 months thereafter. The assessment included the body mass index (BMI) and the HOMA index before meal.

Results: There was a significant positive correlation between BMI and HOMA index, mostly between weight loss and improvement in insulin resistance status (rho = 0.308, p = 0.0335).

Conclusions: BMI decreases significantly after bariatric surgery, which correlates positively with an improvement in insulin resistance status.