scholarly journals Improved acylated ghrelin suppression at 2 years in obese patients with type 2 diabetes: effects of bariatric surgery vs standard medical therapy

2013 ◽  
Vol 38 (3) ◽  
pp. 364-370 ◽  
Author(s):  
S K Malin ◽  
A Samat ◽  
K Wolski ◽  
B Abood ◽  
C E Pothier ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Medical Therapy ◽  
Acylated Ghrelin ◽  
Obese Patients ◽  
Standard Medical Therapy

Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes

2017 ◽  
Author(s):  
Michael Choi ◽  
Miguel Burch
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Medical Therapy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Obese Female ◽  
Patients With Diabetes ◽  
Study Intervention

This chapter provides a summary of a landmark study in bariatric surgery. In obese patients with uncontrolled type 2 diabetes, does bariatric surgery plus intensive medical therapy achieve improved glycemic control in significantly more patients than medical therapy alone? Starting with that question, this chapter describes the basics of the study, including funding, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, criticisms, and limitations. The chapter also briefly reviews other relevant studies and information, discusses implications and concludes with a relevant clinical case about bariatric surgery for a morbidly obese female patient with a BMI of 37 and type 2 diabetes.

scholarly journals The Effects of Bariatric Procedures versus Medical Therapy for Obese Patients with Type 2 Diabetes: Meta-Analysis of Randomized Controlled Trials

2013 ◽  
Vol 2013 ◽  
pp. 1-11 ◽  
Author(s):  
Xiaohu Guo ◽  
Xiaoyan Liu ◽  
Mancai Wang ◽  
Fengxian Wei ◽  
Yawu Zhang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Randomized Controlled Trials ◽  
Medical Therapy ◽  
Biomedical Literature ◽  
Lipid Lowering ◽  
Controlled Trials ◽  
Obese Patients ◽  
Randomized Controlled

Objective. To assess the effects of bariatric surgery versus medical therapy for type 2 diabetes mellitus.Methods. The Cochrane library, PubMed, Embase, Chinese biomedical literature database, and Wanfang database up to February 2012 were searched. The literature searches strategies contained terms (“diabetes*”, “surg*”, and “medic*” were used), combined with the medical subject headings. Randomized controlled trails (RCTs) of frequently used bariatric surgery for obese patients with type 2 diabetes were included. Study selection, data extraction, quality assessment, and data analyses were performed according to the Cochrane standards.Results. Three randomized controlled trials (RCTs) involving 170 patients in the bariatric surgery groups and 100 patients in the medical therapy group were selected. Compared with medical therapy, bariatric surgery for type 2 diabetes can significantly decrease the levels of HbA1c, FBG, weight, triglycerides, and the dose of hypoglycemic, antihypertensive, and lipid-lowering medicine, while increasing the rate of diabetes remission (RR = 9.74, 95%CI, (1.36, 69.66)) and the levels of high-density lipoprotein. However, there are no statistical differences in serious adverse events between the surgical and medical groups (RR = 1.23, 95%CI, (0.80, 1.87)).Conclusions. Surgical procedures were more likely to help patients achieve benefits than medical therapy alone. Further intensive RCTs of high-quality, multiple centers and long-term followup should be carried out to provide more reliable evidence.

A Nationwide Safety Analysis of Bariatric Surgery In Nonmorbidly Obese Patients With Type 2 Diabetes

2015 ◽  
Vol 11 (6) ◽  
pp. S18-S19
Author(s):  
Ali Aminian ◽  
John Kirwan ◽  
Bartolome Burguera ◽  
Stacy Brethauer ◽  
Philip Schauer
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Safety Analysis ◽  
Obese Patients

Abstract 15004: Bariatric Surgery is Associated With Reduced Atherosclerotic Cardiovascular Disease Burden in Obese Patients With Type 2 Diabetes: A Propensity-matched Cohort Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Francesca Watson ◽  
Maddalena Ardissino ◽  
Ravi J Amin ◽  
Chanpreet Arhi ◽  
Peter Collins ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Disease Burden ◽  
Atherosclerotic Cardiovascular Disease ◽  
Obese Patients ◽  
Matched Cohort ◽  
All Cause Mortality

Introduction: Obesity is an increasingly prevalent global health issue and has a considerable disease burden, including numerous co-morbidities. Atherosclerotic cardiovascular disease (ASCVD) is one such co-morbidity associated with a high mortality rate and prevalence, especially in patients with obesity and concomitant Type 2 diabetes mellitus (T2DM). Bariatric surgery is an effective intervention for patients with obesity, shown to reduce overall cardiovascular disease risk. However, few studies have quantified the long-term impact of bariatric surgery on ASCVD outcomes in the context of key co-morbidities such as T2DM. Hypothesis: Bariatric surgery will improve long-term ASCVD outcomes in obese patients with T2DM. Methods: A nested, nationwide, propensity-matched cohort study was carried out using the Clinical Practice Research Datalink. The study cohort included 593 patients who underwent bariatric surgery and had no past history of ASCVD. A further 593 patients served as propensity-score matched controls. Patients were followed up for a median time of 47.2 months. The primary composite study endpoint was the incidence of ASCVD defined by a diagnosis of new coronary artery disease (CAD), cerebrovascular disease (CeVD), peripheral arterial disease (PAD), or other miscellaneous atherosclerotic disease. Secondary endpoints included all-cause mortality and the incidence of CAD, CeVD, and PAD individually. Results: Patients who underwent bariatric surgery had significantly lower rates of new ASCVD during follow-up (HR 0.53, CI 0.30-0.95, p=0.032). No significant difference was observed in rates of new CAD (HR 0.69, CI 0.32-1.46, p=0.331), CeVD (HR 0.23, CI 0.00-5.45, p=0.1760) and PAD (HR 0.55, CI 0.21-1.43, p=0.218). The bariatric surgery group also had a lower rate of all-cause mortality (HR 0.36, CI 0.19-0.71, p=0.003) compared to controls. Conclusions: In this study, bariatric surgery was associated with improved ASCVD outcomes, as well as lower all-cause mortality, in patients with obesity and T2DM. These findings support the use of bariatric surgery in treating obesity and reducing the burden of its related comorbidities.

scholarly journals Cost-Effectiveness of Bariatric Surgery versus Medication Therapy for Obese Patients with Type 2 Diabetes in China: A Markov Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Bin Wan ◽  
Nan Fang ◽  
Wei Guan ◽  
Haixia Ding ◽  
Ying Wang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Health Care ◽  
Health Insurance ◽  
Cost Effectiveness ◽  
Time Horizon ◽  
Obese Patients ◽  
Medication Therapy ◽  
Insurance Payer

Aims/Introduction. The present study estimated the cost-effectiveness of bariatric surgery versus medication therapy for the management of recently diagnosed type 2 diabetes mellitus (T2DM) in obese patients from a Chinese health insurance payer perspective. Materials and Methods. A Markov model was established to compare the 40-year time costs and quality-adjusted life-years (QALYs) between bariatric surgery and medication therapy. The health-care costs in the bariatric surgery group, proportion of patients in each group with remission of diabetes, and state transition probabilities were calculated based on observed resource utilization from the hospital information system (HIS). The corresponding costs in the medication therapy group were derived from the medical insurance database. QALYs were estimated from previous literature. Costs and outcomes were discounted 5% annually. Results. In the base case analysis, bariatric surgery was more effective and less costly than medication therapy. Over a 40-year time horizon, the mean discounted costs were 86,366.55 RMB per surgical therapy patient and 113,235.94 CNY per medication therapy patient. The surgical and medication therapy patients lived 13.46 and 10.95 discounted QALYs, respectively. Bariatric surgery was associated with a mean health-care savings of 26,869.39 CNY and 2.51 additional QALYs per patient compared to medication therapy. Uncertainty around the parameter values was tested comprehensively in sensitivity analyses, and the results were robust. Conclusions. Bariatric surgery is a dominant intervention over a 40-year time horizon, which leads to significant cost savings to the health insurance payer and increases in health benefits for the management of recently diagnosed T2DM in obese patients in China.

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