scholarly journals Metabolic surgery for type II diabetes: an update

2021 ◽  
Author(s):  
Paolo Gentileschi ◽  
Emanuela Bianciardi ◽  
Domenico Benavoli ◽  
Michela Campanelli
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
Type Ii Diabetes ◽  
Scientific Evidence ◽  
Dramatic Improvement ◽  
Type Ii ◽  
Surgical Interventions ◽  
Bariatric Metabolic Surgery

AbstractBariatric operations have been documented in clinical trials to promote remission or dramatic improvement of Type II Diabetes Mellitus and related comorbidities. Herein we review randomized trials and meta-analyses published during the last 20 years on the results of bariatric/metabolic surgery in obese patients with type 2 diabetes with the aim of highlighting the scientific evidence available. Several studies and RCTs in the last 20 years have showed outstanding results of bariatric/metabolic surgery on Type II diabetes and comorbidities in patients with either BMI > 35 kg/m2 or BMI < 35 kg/m2. They have established that bariatric procedures are superior to non-surgical interventions for inducing weight loss and amelioration of type 2 diabetes, even in patients with a BMI between 30 and 35 kg/m2. The physiopatologic changes that improve glucose homeostasis after bariatric surgery remain unclear but glycemic control is improved after sleeve gastrectomy, duodenal-jejunal bypass, Roux-en-Y gastric bypass, gastric banding, One Anastomosis Gastric Bypass, and biliopancreatic diversion. Nevertheless, it is suggested that the various gastrointestinal procedures may have different effects and mechanisms of action. Metabolic surgery will help integrate knowledge and multidisciplinary expertise to provide a combination of conservative and surgical treatments for Type II diabetes. These treatments must be considered as complementary options and not alternative strategies, with the same goal of controlling diabetes and achieving cure.

scholarly journals Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Metabolic Surgery ◽  
First Generation ◽  
Hemoglobin A1c ◽  
Diabetes Remission ◽  
Factors Associated ◽  
Generation Immigrant

IntroductionBariatric and metabolic surgery is an effective treatment option for type 2 diabetes (T2D). Increased knowledge regarding factors associated with diabetes remission is essential in individual decision making and could guide postoperative care. Therefore, we aimed to explore factors known to affect the chance of achieving diabetes remission after bariatric and metabolic surgery and to further investigate the impact of socioeconomic factors.Research design and methodsIn this nationwide study, we assessed all patients with T2D who underwent Roux-en-Y gastric bypass (RYGB) surgery between 2007 and 2015 in the Scandinavian Obesity Surgery Registry. Remission was defined as absence of antidiabetic medication for T2D 2 years after surgery. Multivariable logistic regression was used to evaluate factors associated with diabetes remission, with missing data handled by multiple imputations.ResultsA total of 8057 patients were included. Mean age±SD was 47.4±10.1 years, mean body mass index 42.2±5.7 kg/m2, mean hemoglobin A1c 59.0±17.33, and 61.7% (n=4970) were women. Two years after surgery, 6211 (77.1%) patients achieved T2D remission. Preoperative insulin treatment (OR 0.26, 95% CI 0.22 to 0.30), first-generation immigrant (OR 0.66, 95% CI 0.57 to 0.77), duration of T2D (OR 0.89, 95% CI 0.88 to 0.90), dyslipidemia (OR 0.71, 95% CI 0.62 to 0.81), age (OR 0.97, 95% CI 0.96 to 0.97), and high glycosylated hemoglobin A1c (HbA1c) (OR 0.99, 95% CI 0.98 to 0.99) were all associated with lower T2D remission rate. In contrast, residence in a medium-sized (OR 1.39, 95% CI 1.20 to 1.61) or small (OR 1.46, 95% CI 1.25 to 1.71) town and percentage of total weight loss (OR 1.04, 95% CI 1.03 to 1.04) were associated with higher remission rates.ConclusionAmong patients with T2D undergoing RYGB surgery, increasing age, HbA1c, and diabetes duration decreased the chance of reaching diabetes remission without cut-offs, while postoperative weight loss demonstrated a positive linear association. In addition, being a first-generation immigrant and living in a large city were socioeconomic factors having a negative association.

scholarly journals Bariatric/Metabolic Surgery in Type 1 and Type 2 Diabetes Mellitus

2019 ◽  
Vol 51 (1) ◽  
pp. 85-89
Author(s):  
Mufide Nuran Akcay ◽  
◽  
Erdem Karadeniz ◽  
Ali Ahiskalioglu ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Metabolic Surgery ◽  
Bariatric Metabolic Surgery

DIABETIC STRIATOPATHY: A RARE PRESENTATION OF NONKETOTIC HYPERGLYCEMIA

2021 ◽  
pp. 108-109
Author(s):  
Ranjan Mallick ◽  
Shyam Sunder Hembram ◽  
Ram Chandra Bhadra Chandra Bhadra
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type Ii Diabetes ◽  
Western Europe ◽  
Rare Complication ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Rare Presentation ◽  
Acute Hyperglycaemia

Type II Diabetes Mellitus is one of the most common non-communicable diseases with innumerable & potentially life threatening complications. In 2017, approximately 462 million individuals were affected by type 2 diabetes corresponding to 6.28% of the world's population (4.4% of those aged 15-49 years, 15% of those aged 50-69, and 22% of those aged 70+), or a prevalence rate of 6059 cases per 100,000. Over 1 million deaths per year can be attributed to diabetes alone, making it the ninth leading cause of mortality. The burden of diabetes mellitus is rising globally, and at a much faster rate in developed regions, such as Western Europe. The gender distribution is equal, and the incidence peaks at around 55 years of age. Global prevalence of type 2 diabetes is projected to increase to 7079 individuals per 100,000 by 2030, reecting a continued rise across all regions of the world.[¹] . Two of the common complications due to acute hyperglycaemia are Diabetic Ketocidosis & Non ketotic hyperosmolar coma which are considered a spectrum of the same complication due to low circulating levels of insulin leading to impaired glucose metabolism by insulin dependant tissues with rising levels of anti-insulin hormones like glucagon, cortisol & catecholamines due to intracellular starvation resulting in hypergylcemia & fatty acid breakdown & ketonemia. Amongst the numerous complications of Type II Diabetes Mellitus, here we present a rare complication of acute hyperglycaemia and its radiological picture in the central nervous system. A 56 year old female patient with a history of Type II Diabetes Mellitus with Hypertension under long term medication came for a private consultation with a complaint of Right sided involuntary, random, irregular, inging and ailing, rapid, non-patterned movements for past 7 days. The patient was advised for an urgent MRI of Brain which demonstrated high T1 signal & low T2/FLAIR intensity with no diffusion restriction of DWI & ADC map in left sided putamen & head of caudate nucleus. We illustrated a rare classical nding of acute hyperglycemic effect on brain in a case of long standing Type II Diabetes Mellitus despite being on medications

scholarly journals Elevated serum uric acid and triglycerides level in the patients with Type II Diabetes Mellitus- a Nepalese case control study

2017 ◽  
Vol 2 (2) ◽  
pp. 26-34
Author(s):  
Hridaya Parajuli ◽  
Jyotsna Shakya ◽  
Bashu Dev Pardhe ◽  
Puspa Raj Khanal ◽  
Narayan Prasad Parajuli ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Uric Acid ◽  
Serum Uric Acid ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Type Ii ◽  
Significant Difference

Background: Hyperuricemia is associated with type 2 diabetes, which is a metabolic disorder of multiple etiologies resulting from defects in insulin action. The present study wascarried out to look for any association between uric acid and Type II Diabetes Mellitus and also status of triacylglycerol level among those patients.Methods: The blood samples were collected 100 diabetic and 100 non-diabetic individuals in the department of biochemistry and then analyzed for estimation of blood glucose, Uric Acid and Triacylglycerol level.Results: The average level of serum uric acid in diabetic patients was higher (5.706±1.617) in comparison to non diabetic subjects (4.322±0.784) with statistically significant difference (p≤0.05). For female the result indicate there was a positive correlation between (FBS and triglycerides) and (triglycerides and uric acids) which was statistically significant (r =-0.465, n = 41, p = 0.002) and(r =-0.370, n = 41, p = 0.017) respectively.Conclusions: This study documents that hyperuricemia is associated with type 2 diabetes mellitus. Furthermore, the serum triacylglycerol and serum uric acid is also found to be associated risk factors for diabetic complications. Hence, timely diagnosis and management of diabetes is vital to control the complications related to diabetes.Ann. Clin. Chem. Lab. Med. 2016:2(1); 26-34

scholarly journals Influence of Glycated Haemoglobin Levels on Intraocular Pressure in patients with Type –II Diabetes Mellitus

2019 ◽  
Vol 11 (1) ◽  
pp. 19-23
Author(s):  
Ajai Agrawal ◽  
Shubham Ahuja ◽  
Anupam Singh ◽  
Ramanuj Samanta ◽  
Sanjeev Kumar Mittal
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Intraocular Pressure ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Group I ◽  
Hba1c Levels

Introduction: Patients with diabetes mellitus are at a higher risk of developing primary open angle glaucoma (POAG) as compared to non-diabetic patients. Objectives: To determine whether there is a correlation between hyperglycemic levels and intraocular pressure (IOP) and to identify patients of Type II diabetes mellitus who are at a higher risk of developing glaucoma. Materials and Methods: This was a hospital based, cross sectional study performed on patients with type II diabetes mellitus, at a tertiary health care center in Uttarakhand, India between July, 2018 and September, 2018. 318 eyes of 159 patients with Type2 diabetes mellitus were included in the study. IOP was measured by Goldmannappla nation to no meter and central corneal thickness was measured with specula microscope in all patients, in addition to glycated hemoglobin levels (HbA1c) and fasting and post-prandial blood glucose levels. The data was analysed using SPSS 22 software. Results: Mean IOP was found to be 15.75 ± 3.18 mm Hg in patients with HbA1c levels between 6.5%-12% (Group I) and 17.42 ± 2.67 mm Hg in patients with HbA1c levels more than 12 % (Group II). The difference between the two groups was statistically significant (P =0.013). Out of 159 patients with Type 2 Diabetes mellitus, a total of 11 patients had IOP more than 21mm Hg in one or both the eyes. Conclusion: Hyperglycaemic levels as determined by raised HbA1c levels are associated with higher intraocular pressures in patients with type 2 diabetes mellitus.

Metabolic Surgery in Type 2 Diabetes: Roux-en-Y Gastric Bypass or Sleeve Gastrectomy as Procedure of Choice?

2015 ◽  
Vol 17 (10) ◽  
Author(s):  
Josep Vidal ◽  
Amanda Jiménez ◽  
Ana de Hollanda ◽  
Lílliam Flores ◽  
Antonio Lacy
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Metabolic Surgery

scholarly journals Clinical evaluation of an Ayurvedic Formulation in the management of Avaranajanya Madhumeha (Type 2 Diabetes Mellitus)

2019 ◽  
Vol 1 ◽  
pp. 50-64
Author(s):  
DEVASHISH BHARDWAJ ◽  
VEENIT K. AGNIHOTRI ◽  
PRANAV PANDYA
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Blood Sugar ◽  
Type Ii Diabetes ◽  
Type Ii Diabetes Mellitus ◽  
Type Ii ◽  
Research Plan ◽  
Urine Sugar ◽  
Diabetes Patients

A research plan has been developed in the present study to address the problems associated with Avaranajanya Madhumeha (type 2 diabetes). This research plan is based on the treatment methods of Ayurveda (ancient Indian medicine) and utilization of modern scientific methods as research tools. A specific ayurvedic herbo-mineral formulation has been prepared in Ghansatt (solid extract) form; the selected eight herbs and one herbo-mineral have anti-hyperglycemic (PRAMEHA HARA) and antihypercholestermic (MEDOHARA) properties with rejuvenative (RASAYANA) effects as described in classical ayurvedic methods. 15 diagnosed type II diabetes mellitus patients were selected through accidental sampling. Ayurvedic formulation was prescribed to type II diabetes patients for one year along with dietary restrictions. Diabetic diagnostic parameters of these patients like Fasting Blood Sugar (FBS), Post Patrum Blood Sugar (PPBS), Glycocylated Hemoglobin (HbA1C) and Urine Sugar Fasting were monitored every three months; these were measured before and after intervention. The obtained data were statistically analyzed through paired t-test. There was significant reduction in FBS level, PPBS level, HbA1C level and urine fasting sugar level in type 2 diabetes patients who completed the clinical trial successfully. Thus, ayurvedic formulation treatment lead to an overall significant reduction in blood sugar and urine sugar levels in type II diabetes patients. No side effects were noted during the study period. This study suggests that the ayurvedic formulation had very good hypoglycemic effects proved by clinical improvement and bio-chemical analysis of diabetes parameters in the treatment of type II diabetes mellitus.

scholarly journals Dependence of Retinopathy (and other Complications) on Glycaemic Control and on Weight over 5/10 Years from Diagnosis of Type II Diabetes

1996 ◽  
Vol 89 (1) ◽  
pp. 27-30 ◽  
Author(s):  
B J Boucher ◽  
J Tsoumanis ◽  
K Noonan ◽  
J Holmes
Keyword(s):  
Type 2 Diabetes ◽  
Glycaemic Control ◽  
Type Ii Diabetes ◽  
Type Ii ◽  
Peripheral Vascular ◽  
Initial Weight ◽  
Weight Fluctuation ◽  
Good Glycaemic Control ◽  
Glycosylated Haemoglobins

Glycosylated haemoglobins and weights were recorded for 200 consecutive diabetic clinic attendere seen yearly for 5 years, 76 of whom were also seen up to 10 years from diagnosis of type 2 diabetes, representing 1380 patient years. Weight fluctuation (≥3 kg) was associated with increased final prevalence of hypertension, macroalbuminaemia and a raised creatinine (P≤ 0.002) but this relationship was abolished by correction for higher initial weight. Average giycaemia over 5/10 years [itself related to initial weight in women on tablets (N=53) but not others, and to waist but not waist/hip ratio], correlated with prevalence and severity of retinopathy (N=200; r=0.38, P≤0.0006) seen also in the subgroup of patients on tablets (N=145, P≤0.006). At HbA1 levels ≥10.5% an increased prevelance of retinopathy was seen in those on insulin (W=37, P≤0.001) and an increased prevalence of peripheral vascular disease was seen in men but not women (x2=2.87, P≤0.01) as well as in the prevalence of neuropathy. These findings suggest that good glycaemic control is of value in type 2 diabetes and less easily achieved in obesity.

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