<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1405-0099</journal-id>
<journal-title><![CDATA[Cirujano general]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. gen]]></abbrev-journal-title>
<issn>1405-0099</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Cirugía General A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1405-00992018000400238</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Disminución en el uso de insulina en pacientes diabéticos operados de cirugía bariátrica]]></article-title>
<article-title xml:lang="en"><![CDATA[Decrease in insulin use in diabetic patients operated on bariatric surgery]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Adame-García]]></surname>
<given-names><![CDATA[Ivan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Montoya-Ramírez]]></surname>
<given-names><![CDATA[Jesús]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Blas-Azotla]]></surname>
<given-names><![CDATA[Ricardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Méndez-Ibarra]]></surname>
<given-names><![CDATA[Jorge Uriel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ballesteros-Barrera]]></surname>
<given-names><![CDATA[Irving Federico]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado Centro Médico Nacional 20 de Noviembre Departamento de Cirugía Bariátrica]]></institution>
<addr-line><![CDATA[Ciudad De México ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital General de Puebla &#8220;Dr. Eduardo Vázquez Navarro&#8221; Departamento de Cirugía General Servicios de Salud del Estado de Puebla]]></institution>
<addr-line><![CDATA[Puebla ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2018</year>
</pub-date>
<volume>40</volume>
<numero>4</numero>
<fpage>238</fpage>
<lpage>242</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1405-00992018000400238&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1405-00992018000400238&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1405-00992018000400238&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen:  Introducción:  La obesidad es una acumulación anormal y excesiva de tejido adiposo que afecta el estado de salud. De acuerdo con la Organización Mundial de la Salud la obesidad se define como un índice de masa corporal de 30 kg/m2 o más. La importancia de la obesidad radica en las comorbilidades asociadas que pueden presentarse como diabetes mellitus, hipertensión, enfermedades del corazón, enfermedades respiratorias y otras. En los últimos años ha aumentado la incidencia de sobrepeso y obesidad y con ella la de la diabetes mellitus. La cirugía bariátrica ha demostrado un aumento en la pérdida del exceso de peso y la mejoría de las comorbilidades, incluso se ha reportado la remisión de la diabetes mellitus. El objetivo de este estudio es determinar el efecto de la cirugía bariátrica en pacientes con diabetes mellitus tratados con insulina en un periodo de cinco años en el Hospital Centro Médico Nacional 20 de Noviembre, ISSSTE de la Ciudad de México.  Material y métodos:  Se trata de un estudio de tipo retrospectivo, transversal y analítico con 523 pacientes sometidos a cirugía bariátrica en el Hospital del Centro Médico Nacional 20 de Noviembre en un periodo comprendido entre el 01 de enero de 2011 y el 31 de octubre de 2016. Se seleccionaron 35 pacientes tratados con insulina. Se realizó una prueba de Kolmogorov-Smirnov para determinar la distribución de la normalidad de las muestras y se utilizó la prueba t de Student.  Resultados:  Se seleccionó un total de 35 pacientes obesos tratados con insulina y sometidos a cirugía bariátrica, 77% fueron mujeres y 23% varones, con una edad media de 50 años, el tiempo de evolución con diabetes mellitus con una media de 10.3 años, el periodo de uso de insulina con una media de 37.4 meses, con un HBA1c de 9.4%, los procedimientos realizados fueron de 20 gastrectomías en manga, 12 derivaciones gástricas y tres bandas gástricas.  Conclusión:  La mayoría de los pacientes operados de cirugía bariátrica ya no requieren el uso de insulina, la importancia de 91.4% de los pacientes operados en nuestro estudio reside en que genera un impacto en la calidad de vida y en el aspecto económico, la cirugía bariátrica disminuye el uso de insulina, ofreciendo así mejor calidad de vida, menos comorbilidades y menor impacto económico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Obesity is an abnormal and excessive accumulation of adipose tissue that affects the state of health (WHO), obesity is define as a BMI of 30 kg/m2 or greater. The importance of obesity is the comorbidities associated like diabetes mellitus, hypertension, heart disease, respiratory disease, and others. In recent years has increased the incidence of overweight and obesity and with that the diabetes mellitus. Bariatric surgery has shown an increase in excess weight loos and improvement of comorbidities, including remission of diabetes mellitus. The object of this study is to define the effect of bariatric surgery in patient with diabetes mellitus treated with insulin in a period of five years, in The National Medical Center Hospital 20 de Noviembre, ISSSTE, of Mexico city.  Material and methods:  In this retrospective, longitudinal, analytic study, with 523 patient undergoing bariatric surgery at The 20 de Noviembre Medical Center Hospital, in a period of 01 January 2011 to 31 October 2016. Only 35 patients were treated whit insulin. Kolmogorov-Smirnov test was performed to determine the distribution of normality of the samples, the Student&#8217;s t test was used.  Result:  35 obese patients were on insulin treatment, and underwent bariatric surgery, 77% were female and 23% were male, mean age 50 years, suffering from diabetes mellitus with the mean of 10.3 years, the period of time using insulin with a mean of 37.4 months, with a HBA1c of 9.4%, the procedures performed were 20 sleeve gastrectomies, 12 gastric bypasses and 3 gastric bands.  Conclusion:  The majority of the patient no longer required insulin, 91.4% of patients in our study, the importance lies in the impact on the quality of life, and on the economic impact, we show that bariatric surgery decreases the use of insulin.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Cirugía bariátrica]]></kwd>
<kwd lng="es"><![CDATA[obesidad]]></kwd>
<kwd lng="es"><![CDATA[insulina y obesidad]]></kwd>
<kwd lng="es"><![CDATA[diabetes mellitus]]></kwd>
<kwd lng="en"><![CDATA[Bariatric surgery]]></kwd>
<kwd lng="en"><![CDATA[obesity]]></kwd>
<kwd lng="en"><![CDATA[insuline and obesity]]></kwd>
<kwd lng="en"><![CDATA[diabetes mellitus]]></kwd>
</kwd-group>
</article-meta>
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