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
2018 ◽  
Vol 179 (2) ◽  
pp. R77-R93 ◽  
Author(s):  
Adrian T Billeter ◽  
Javier R de la Garza Herrera ◽  
Katharina M Scheurlen ◽  
Felix Nickel ◽  
Franck Billmann ◽  
...  

Obesity and its associated comorbidities have become one of the largest challenges for health care in the near future. Conservative therapy for obesity and related comorbidities has a very high failure rate and poor long-term results. Similarly, the conservative and medical management of the majority of metabolic diseases such as type 2 diabetes mellitus are only able to slow down disease progression but have no causal effect on the disease process. Obesity surgery has evolved as a highly effective therapy for severe obesity achieving long-lasting weight loss. Furthermore, several studies have demonstrated the beneficial effects of obesity surgery on reduction of overall mortality, reduction of cardiovascular events and superior control of obesity-related diseases such as type 2 diabetes mellitus, dyslipidemia and also the non-alcoholic steatohepatitis compared to medical therapy. Based on these findings, the term ‘metabolic surgery’ with the focus on treating metabolic diseases independent of body weight has been coined. Of great interest are recent studies that show that even existing complications of metabolic diseases such as diabetic nephropathy or the non-alcoholic steatohepatitis can be reversed by metabolic surgery. Although metabolic surgery has proven to be a safe and effective treatment for obesity, resolution of comorbidities and enhancing quality of life, it is still uncertain and unclear, which surgical procedure is the most effective to achieve these metabolic effects. The aim of this review is to compare the effects of the two currently most widely used metabolic operations, the Roux-en-Y gastric bypass and the sleeve gastrectomy in the treatment of obesity and its related comorbidities.


2018 ◽  
Author(s):  
Ines Ferreira Barros ◽  
Silvia Paredes ◽  
Fernando Manso ◽  
Costa Jose Manuel Maia da ◽  
Aline Fernandes ◽  
...  

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 78-OR
Author(s):  
FARHAT FATIMA ◽  
JØRAN HJELMESÆTH ◽  
KARE I. BIRKELAND ◽  
HANNE L. GULSETH ◽  
JENS K. HERTEL ◽  
...  

2021 ◽  
Vol 9 (1) ◽  
pp. e002033
Author(s):  
Erik Stenberg ◽  
Torsten Olbers ◽  
Yang Cao ◽  
Magnus Sundbom ◽  
Anders Jans ◽  
...  

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.


2021 ◽  
Vol 261 ◽  
pp. 407-416
Author(s):  
Richard D. Nudotor ◽  
Gregory Prokopowicz ◽  
Enoch J. Abbey ◽  
Aldo Gonzalez ◽  
Joseph K. Canner ◽  
...  

Appetite ◽  
2016 ◽  
Vol 107 ◽  
pp. 93-105 ◽  
Author(s):  
Janine M. Makaronidis ◽  
Sabrina Neilson ◽  
Wui-Hang Cheung ◽  
Urszula Tymoszuk ◽  
Andrea Pucci ◽  
...  

2019 ◽  
Vol 4 (2) ◽  
pp. 109-115
Author(s):  
M.A. Mansour ◽  
R.S. Salama ◽  
M.A. Elbegawy ◽  
M.E. Ahmed

2018 ◽  
Vol 28 (9) ◽  
pp. 2672-2686 ◽  
Author(s):  
Reza Nemati ◽  
Jun Lu ◽  
Dech Dokpuang ◽  
Michael Booth ◽  
Lindsay D. Plank ◽  
...  

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