{"id":772,"date":"2019-01-23T12:13:35","date_gmt":"2019-01-23T11:13:35","guid":{"rendered":"http:\/\/www.medespoir.ch\/blog\/?p=772"},"modified":"2019-11-07T10:07:18","modified_gmt":"2019-11-07T09:07:18","slug":"guerison-diabete-apres-bypass","status":"publish","type":"post","link":"https:\/\/www.medespoir.ch\/blog\/guerison-diabete-apres-bypass\/","title":{"rendered":"Gu\u00e9rit-on du diab\u00e8te apr\u00e8s un bypass gastrique ?"},"content":{"rendered":"

[flexy_breadcrumb]<\/p>\n

Il est reconnu que l\u2019une des complications de l\u2019ob\u00e9sit\u00e9 est le diab\u00e8te de type 2. Ce n\u2019est d\u2019ailleurs pas la seule comorbidit\u00e9 associ\u00e9e \u00e0 l\u2019ob\u00e9sit\u00e9, car il y a aussi la dyslipid\u00e9mie, l\u2019hypertension art\u00e9rielle, l\u2019infarctus du myocarde, cataracte, l\u2019apn\u00e9e du sommeil, etc. Si la chirurgie bariatrique, notamment le bypass gastrique entra\u00eene une perte de poids, on lui reconna\u00eet aussi un autre b\u00e9n\u00e9fice, celui de gu\u00e9rir du diab\u00e8te. Qu\u2019en est-il r\u00e9ellement de ce b\u00e9n\u00e9fice m\u00e9tabolique du bypass gastrique ? <\/p>\n

C\u2019est quoi le bypass ?<\/h2>\n

Le bypass est une intervention qui consiste \u00e0 r\u00e9duire le volume de l\u2019estomac tout en modifiant le circuit alimentaire en proc\u00e9dant au court-circuitage d\u2019une partie de l\u2019estomac. Il en r\u00e9sulte une malabsorption qui s\u2019associe \u00e0 la restriction. <\/p>\n

Mythe ou r\u00e9alit\u00e9 ? <\/h2>\n

La r\u00e9mission du diab\u00e8te apr\u00e8s un bypass n\u2019est pas un mythe. Il s\u2019agit le plus souvent d\u2019une r\u00e9mission partielle. On \u00e9value \u00e0 72% \u00e0 2 ans, et \u00e0 30% \u00e0 15 ans, ce taux de r\u00e9mission. 1 an apr\u00e8s une chirurgie de l\u2019ob\u00e9sit\u00e9 par bypass<\/a>, on \u00e9value ce taux de r\u00e9mission \u00e0 57%.
\nOn estime en effet que 90% des cas de diab\u00e8te se trouvent r\u00e9solus apr\u00e8s un bypass, contrairement \u00e0 la pose d\u2019un anneau gastrique ou d\u2019une sleeve gastrectomie. Ceci serait d\u00fb au fait que le bypass gastrique permet d\u2019am\u00e9liorer plus nettement la sensibilit\u00e9 du patient \u00e0 l\u2019insuline et \u00e0 l\u2019augmentation de sa s\u00e9cr\u00e9tion. Son impact sur l\u2019hom\u00e9ostasie glucidique est si s\u00fbr que certains chirurgiens n\u2019h\u00e9sitent pas \u00e0 la recommander comme traitement du diab\u00e8te de type 2. Il est d\u2019ailleurs affirm\u00e9 par certains qu\u2019en ce qui concerne la prise en charge de ce type de diab\u00e8te, le traitement chirurgical par bypass serait plus efficace que le traitement m\u00e9dical du diab\u00e8te. <\/p>\n

Bypass et hypoglyc\u00e9mie <\/h2>\n

N\u00e9anmoins, on constate qu\u2019apr\u00e8s un bypass chez certains patients ob\u00e8ses, il se manifeste un d\u00e9s\u00e9quilibre entre la sensibilit\u00e9 \u00e0 l\u2019insuline et sa s\u00e9cr\u00e9tion. Ce qui peut alors provoquer une hypoglyc\u00e9mie hyperinsulin\u00e9mique tardive qui peut donc s\u2019av\u00e9rer handicapante. L\u2019hypoglyc\u00e9mie est d\u2019ailleurs l\u2019une des complications tardives du bypass. <\/p>\n

Quid de l\u2019hypertension art\u00e9rielle ? <\/h2>\n

De mani\u00e8re g\u00e9n\u00e9rale, la plupart des comorbidit\u00e9s associ\u00e9es \u00e0 l\u2019ob\u00e9sit\u00e9 peuvent \u00eatre facilement contr\u00f4l\u00e9es apr\u00e8s un bypass. C\u2019est pourquoi on pense que la chirurgie bariatrique am\u00e9liore la qualit\u00e9 de vie du patient. Le plus souvent, c\u2019est la perte de poids elle-m\u00eame qui d\u00e9termine l\u2019effet de la chirurgie de l\u2019ob\u00e9sit\u00e9. Toujours est-il que ce n\u2019est pas seulement le diab\u00e8te et l\u2019hypertension art\u00e9rielle qui rencontrent une am\u00e9lioration apr\u00e8s la chirurgie de l\u2019ob\u00e9sit\u00e9, mais aussi les dyslipid\u00e9mies, l\u2019arthrose, les douleurs ost\u00e9oarticulaires, l\u2019asthme, la fonction cardiaque, etc. <\/p>\n","protected":false},"excerpt":{"rendered":"

[flexy_breadcrumb] Il est reconnu que l\u2019une des complications de l\u2019ob\u00e9sit\u00e9 est le diab\u00e8te de type 2. Ce n\u2019est d\u2019ailleurs pas la seule comorbidit\u00e9 associ\u00e9e \u00e0 l\u2019ob\u00e9sit\u00e9, car il y a aussi la dyslipid\u00e9mie, l\u2019hypertension art\u00e9rielle, l\u2019infarctus du myocarde, cataracte, l\u2019apn\u00e9e du sommeil, etc. Si la chirurgie bariatrique, notamment le bypass gastrique entra\u00eene une perte de poids, on lui reconna\u00eet aussi un autre b\u00e9n\u00e9fice, celui de gu\u00e9rir du diab\u00e8te. Qu\u2019en est-il r\u00e9ellement de ce b\u00e9n\u00e9fice m\u00e9tabolique du bypass gastrique ? C\u2019est…<\/p>\n

Lire la suite Lire la suite<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":777,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34,1],"tags":[],"class_list":["post-772","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-non-classifiee"],"yoast_head":"\nBypass et diab\u00e8te : bypass gastrique pour gu\u00e9rir diab\u00e8te<\/title>\n<meta name=\"description\" content=\"Bypass et diab\u00e8te : Bypass gastrique pour gu\u00e9rir des patients diab\u00e9tiques, r\u00e9duire le volume de l\u2019estomac tout en modifiant le circuit alimentaire\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.medespoir.ch\/blog\/guerison-diabete-apres-bypass\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta 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