scholarly journals Predictors of normalized HbA1c after gastric bypass surgery in subjects with abnormal glucose levels, a 2-year follow-up study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Neda Rajamand Ekberg ◽  
Henrik Falhammar ◽  
Erik Näslund ◽  
Kerstin Brismar
Keyword(s):  
Gastric Bypass ◽  
Waist Circumference ◽  
Gastric Bypass Surgery ◽  
Multiple Regression Model ◽  
Glucose Levels ◽  
Clinical Biomarkers ◽  
Igf I ◽  
Normal Fasting Glucose ◽  
Obese Subjects

Abstract Clinical biomarkers can predict normalization of HbA1c after Roux-en-Y gastric bypass (RYGB) surgery, but it is unclear which are the most predictive.The aim of this study was to compare biomarkers for insulin sensitivity and other clinical parameters in the prediction of normalization of HbA1c after RYGB surgery. This study included 99 (23 men) obese subjects (BMI > 35 kg/m2) undergoing a laparoscopic RYGB. Clinical and biochemical examinations were performed pre-operatively and up to 2 years after surgery. Pre-operatively, normal fasting glucose levels were found in 25 individuals (NG), prediabetes in 46 and type 2 diabetes (T2DM) in 28. At baseline IGF-I (SD), IGFBP-1 and adiponectin levels were low while leptin was high. Weight loss was observed in all three groups, most in the prediabetes group. After 2 years HbA1c was decreased in prediabetes and T2DM. In all three groups insulin, HOMA-IR, lipids and blood pressure improved, IGFBP-1 and adiponectin increased and leptin decreased. IGF-I (SD) increased only in T2DM. In those with prediabetes or T2DM (n = 74), HbA1c at 2 years correlated to baseline BMI (r = -0.27, p = 0.028), age (r = 0.43, p < 0.001), HbA1c (r = 0.37, p = 0.001) and IGFBP-1 (r = 0.25, p = 0.038), and was normalized in 45/74 (61%) at 1 year and in 36 subjects (49%) at 2 years. These responders were younger, had higher BMI, larger waist circumference, lower HbA1c and lower IGFBP-1 levels at baseline. In a multiple regression model age (negative, p = 0.021) and waist circumference (positive, p = 0.047) were the only predictors for normalized HbA1c. RYGB normalized HbA1c in 49% at two years follow-up, which was predicted by low baseline IGFBP-1 level, a marker of hepatic insulin sensitivty and insulin secretion. However,. younger age and larger waist circumference were the only predictors of normalized HbA1c in multivariate analysis.

scholarly journals Differences in Serum Magnesium Levels in Diabetic and Non-Diabetic Patients Following One-Anastomosis Gastric Bypass

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1984
Author(s):  
Winzer ◽  
Grabovac ◽  
Ludvik ◽  
Kruschitz ◽  
Schindler ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Magnesium Deficiency ◽  
Gastric Bypass Surgery ◽  
Serum Magnesium ◽  
One Anastomosis Gastric Bypass ◽  
Diabetic Patients ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Baseline Bmi

Patients with obesity and type 2 diabetes mellitus (T2DM) are regarded to have reduced serum magnesium (Mg) concentrations. We aimed to assess the changes in serum Mg concentrations at 12-month follow-up in patients, with and without T2DM, who underwent one anastomosis gastric bypass surgery. Overall, 50 patients (80% female, age 42.2 (12.5) years) with morbid obesity (mean baseline BMI 43.8 (4.3) kg/m2) were included in the analysis. Half of the included patients had T2DM diagnosed at baseline, and these patients showed lower serum Mg concentration (0.78 (0.07)) vs. 0.83 (0.05) mmol/L; p = 0.006), higher blood glucose levels (129.9 (41.3) vs. 87.6 (8.1) mg/dL; p < 0.001) as well as HbA1c concentrations (6.7 (1.4) vs. 5.3 (0.5)%; p < 0.001). During follow-up, BMI and glucose levels showed a decrease; however, serum Mg levels remained stable. At baseline 42% of patients were found to be Mg deficient, which was reduced to 33% at six months and to 30% at 12 months follow-up. Moreover, patients with T2DM had an odds ratio of 9.5 (95% CI = 3.0–29.7; p < 0.001) for magnesium deficiency when compared to patients without T2DM. Further research into the role of Mg and its role in T2DM and other obesity-related comorbidities are needed.

GLP-1, insulin and glucose levels during mixed test meal before and after gastric bypass surgery in obese patients

2014 ◽  
Author(s):  
Dragan Micic ◽  
Snezana Polovina ◽  
Danka Jeremic ◽  
Dusan Micic ◽  
Mirjana Sumarac-Dumanovic
Keyword(s):  
Gastric Bypass ◽  
Test Meal ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Obese Patients ◽  
Glucose Levels ◽  
Before And After

Long-term-follow-up of patients with gastric bypass surgery secondary to craniopharyngioma associated hypothalamic obesity

2020 ◽  
Author(s):  
Hannes Beiglböck ◽  
Paul Fellinger ◽  
Tamara Ranzenberger-Haider ◽  
Greisa Vila ◽  
Anton Luger ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Hypothalamic Obesity ◽  
Long Term Follow Up

scholarly journals Improved heart rate recovery after marked weight loss induced by gastric bypass surgery: Two-year follow up in the Utah Obesity Study

Heart Rhythm ◽  
2011 ◽  
Vol 8 (1) ◽  
pp. 84-90 ◽  
Author(s):  
Stephen L. Wasmund ◽  
Theophilus Owan ◽  
Frank G. Yanowitz ◽  
Ted D. Adams ◽  
Steven C. Hunt ◽  
...  
Keyword(s):  
Heart Rate ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Heart Rate Recovery ◽  
Gastric Bypass Surgery ◽  
Marked Weight

Long-Term Effects of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Surgery on Type 2 Diabetes Mellitus in Morbidly Obese Subjects

2012 ◽  
Vol 256 (6) ◽  
pp. 1023-1029 ◽  
Author(s):  
Amanda Jiménez ◽  
Roser Casamitjana ◽  
Lílliam Flores ◽  
Judith Viaplana ◽  
Ricard Corcelles ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Morbidly Obese ◽  
Long Term Effects ◽  
Obese Subjects

scholarly journals GLP1 analogs as treatment of postprandial hypoglycemia following gastric bypass surgery: a potential new indication?

2013 ◽  
Vol 169 (6) ◽  
pp. 885-889 ◽  
Author(s):  
Niclas Abrahamsson ◽  
Britt Edén Engström ◽  
Magnus Sundbom ◽  
F Anders Karlsson
Keyword(s):  
Gastric Bypass ◽  
Gastric Bypass Surgery ◽  
Somatostatin Analogs ◽  
Medical Attention ◽  
Morbidly Obese ◽  
Channel Blockers ◽  
Partial Pancreatectomy ◽  
Glucose Levels ◽  
Open Treatment ◽  
New Treatment

ObjectiveThe number of morbidly obese subjects submitted to bariatric surgery is rising worldwide. In a fraction of patients undergoing gastric bypass (GBP), episodes with late postprandial hypoglycemia (PPHG) develop 1–3 years after surgery. The pathogenesis of this phenomenon is not fully understood; meal-induced rapid and exaggerated increases of circulating incretins and insulin appear to be at least partially responsible. Current treatments include low-carbohydrate diets, inhibition of glucose intestinal uptake, reduction of insulin secretion with calcium channel blockers, somatostatin analogs, or diazoxide, a KATP channel opener. Even partial pancreatectomy has been advocated. In type 2 diabetes, GLP1 analogs have a well-documented effect of stabilizing glucose levels without causing hypoglycemia.DesignWe explored GLP1 analogs as open treatment in five consecutive GBP cases seeking medical attention because of late postprandial hypoglycemic symptoms.ResultsGlucose measured in connection with the episodes in four of the cases had been 2.7, 2.5, 1.8, and 1.6 mmol/l respectively. The patients consistently described that the analogs eliminated their symptoms, which relapsed in four of the five patients when treatment was reduced/discontinued. The drug effect was further documented in one case by repeated 24-h continuous glucose measurements.ConclusionThese open, uncontrolled observations suggest that GLP1 analogs might provide a new treatment option in patients with problems of late PPHG.

scholarly journals Liver markers, prevalence of the metabolic syndrome abnormalities and effect of Roux-en-Y gastric bypass in morbidly obese subjects

2011 ◽  
Vol 9 (4) ◽  
pp. 429-435
Author(s):  
Ary Serpa Neto ◽  
Felipe Martin Bianco Rossi ◽  
Rodrigo Dal Moro Amarante ◽  
Marçal Rossi
Keyword(s):  
Metabolic Syndrome ◽  
Gastric Bypass ◽  
Heavy Drinking ◽  
University Hospital ◽  
Morbidly Obese ◽  
Metabolic Abnormalities ◽  
Glucose Levels ◽  
The Metabolic Syndrome ◽  
Obese Subjects ◽  
Liver Markers

ABSTRACT Objectives: To evaluate the relations between liver markers (GGT, ALT and AST) and the metabolic syndrome (and its components) in morbidly obese subjects, and to determine the response of these metabolic factors and hepatic enzymes after weight loss induced by Roux-en-Y gastric bypass. Methods: This study was carried out at a university hospital, in Santo André (SP), Brazil. We evaluated 140 morbidly obese subjects aged from 18 to 60 years submitted to a Roux-en-Y gastric bypass, who were followed for a mean period of 8 months. Patients with a history of heavy drinking, type 1 diabetes, and/or liver disease were excluded. Results: Liver markers, most notably GGT, were strongly associated with metabolic abnormalities, mainly hyperglycemia. The prevalence of type 2 diabetes significantly increased with increasing levels of GGT (highest versus lowest quartile GGT: odds ratio 3.89 [95%CI: 1.07-14.17]). Liver markers significantly decreased 8 months after the Roux-en-Y gastric bypass and the reduction of GGT levels were associated with the reduction of glucose levels (Pearson r = 0.286; p = 0.001). Conclusions: Elevated levels of liver markers, principally GGT, in morbidly obese subjects are associated with metabolic abnormalities. In addition to the well-known benefits of bariatric surgery, Roux-en-Y gastric bypass, reduced the levels of liver markers to the normal range.

scholarly journals Determinants of Adequate Response of Patient Undergoing Roux-en-y Gastric Bypass Surgery

2020 ◽  
Author(s):  
Thales Philipe Rodrigues Silva ◽  
Flávia Moraes Silva ◽  
Larissa Loures Mendes ◽  
Alexandra Dias Moreira D'assunção ◽  
Lauro Pinheiro Ferreira de Araujo ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gastric Bypass ◽  
Logistic Regression ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Inadequate Response ◽  
Post Surgery ◽  
Adequate Response ◽  
Follow Up Care

Abstract INTRODUCTION: Roux-en-Y gastric bypass surgery (RYGB) is known to induce, on average,60 to 75% excess body weight loss between 18 and 24 months post-surgery. However, several studies have shown weight regain after two years post-surgery, thus patients must have adequate follow-up in order to guarantee and/or maintain response to RYGB. AIM: To evaluate the determinants of adequate response in patients who underwent RYGB. METHODS: A longitudinal study with 193 adults who underwent RYGB between 2012 and 2014. Adequate response to RYGB was determined by Excess Weight Loss (%EWL). Logistic regression models were constructed to verify the degree of association between adequate response of patient after RYGB and determinants of variable risk based on estimate Odds Ratios (OR). RESULTS: RYGB improves Systemic arterial hypertension (SAH), Diabetes Mellitus (DM) and body mass index (BMI). From the multivariate logistic regression model, being female and not having SAH and DM reduce the chance of inadequate RYGB response. Regarding preoperative BMI, an increase in one unit of kg/m2 was associated with increased odds of inadequate response after RYGB. And patients who did not receive follow-up care with a psychologist or psychiatrist in the postoperative period presented higher odds of inadequate response to RYGB. CONCLUSION: The findings of this study contribute to the effective planning of interventions by multi-professional teams involved in RYGB, aimed at offering a better follow-up care focused mainly on post-surgery changes and adequate RYGB response.

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