Neurotensin system mediates weight loss response after metabolic surgery

2019 ◽  
Author(s):  
R Chakaroun ◽  
L Scheffler ◽  
S Tabei ◽  
A Tönjes ◽  
M Blüher ◽  
...  
Keyword(s):  
Weight Loss ◽  
Metabolic Surgery

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.

The Prognostic Value of the Dutch Sweet Eating Questionnaire on Weight Loss After Metabolic Surgery: a Randomized Controlled Trial

2020 ◽  
Vol 30 (7) ◽  
pp. 2497-2504
Author(s):  
L. U. Biter ◽  
M. Leeman ◽  
I. Friskes ◽  
M. der Kinderen ◽  
J. A. Apers ◽  
...  
Keyword(s):  
Weight Loss ◽  
Randomized Controlled Trial ◽  
Metabolic Surgery ◽  
Prognostic Value ◽  
Controlled Trial ◽  
Randomized Controlled ◽  
Sweet Eating

scholarly journals P-B01 First Inventory of Access and Quality of Metabolic Surgery across Europe

2021 ◽  
Vol 108 (Supplement_9) ◽  
Author(s):  
Piriyah Sinclair ◽  
Guy Vijgen ◽  
Edo Aarts ◽  
Yves Van Nieuwenhove ◽  
Almantas Maleckas
Keyword(s):  
Weight Loss ◽  
Quality Indicators ◽  
Metabolic Surgery ◽  
Body Contouring ◽  
European Countries ◽  
Quality Data ◽  
Eligibility Criteria ◽  
Body Contouring Surgery ◽  
Patient Pathways ◽  
Access And Quality

Abstract Background Europe consists of 51 independent countries. Variation in healthcare regulations results in differing challenges faced by patients and professionals. The obesity pandemic has multiple health, economic and social implications. However, metabolic surgery is not universally accessible, with significant variations in its provision. This study aimed to gain insight into compliance with international guidelines; the accessibility and barriers to surgery; patient pathways and qualitor indicators of both metabolic and body contouring surgery after weight loss in different European countries. Methods This study was initiated during the European Obesity Academy (EOA). Expert representatives in the metabolic field from all 51 European countries were sent a novel, 37-item, electronic self-administered online questionnaire on their data and experiences from the previous year exploring accessibility to and quality indicators for metabolic surgery and body contouring surgery after weight loss. The survey tool was peer-reviewed by experienced researchers and piloted by fifteen experienced researchers with a spread of seniority and specialty. Content and face validity were ensured by peer-review and the piloting process. 45 completed responses were collected.  Results 68% of countries had eligibility criteria for metabolic surgery; 59% adhered to these. 46% had reimbursement criteria for metabolic surgery. 41% had eligibility criteria for plastic surgery and 31% reimbursement criteria. Average tariffs for a metabolic procedure varied (€800-€ 16000). MDTs were mandated in 78%, with team members varying significantly. Referral practises differed. In 45% metabolic surgery is performed by pure metabolic surgeons. 23% had a metabolic training program. Access to metabolic surgery was rated poor/ very poor in 33%. 35% had a bariatric registry. 24% required a minimum procedure number for metabolic centres; varying from 25 to 200 procedures. Conclusions This is the first study to describe accessibility and quality data on metabolic and body contouring surgery from most European countries. There are myriad differences between European countries in terms of accessibility to metabolic surgery. Lack of funding, education and structure fuels this disparity. We hope this study will impact standardisation of access and quality indicators for metabolic and body contouring surgery across European countries, as well as be a springboard for further evaluation of international metabolic surgery practices.

Metabolic surgery improves renal injury independent of weight loss: a meta-analysis

2019 ◽  
Vol 15 (6) ◽  
pp. 1006-1020 ◽  
Author(s):  
Katharina M. Scheurlen ◽  
Pascal Probst ◽  
Stefan Kopf ◽  
Peter P. Nawroth ◽  
Adrian T. Billeter ◽  
...  
Keyword(s):  
Weight Loss ◽  
Metabolic Surgery ◽  
Renal Injury ◽  
Meta Analysis

Managing Care of Critically Ill Bariatric Patients

2017 ◽  
Vol 28 (3) ◽  
pp. 275-283 ◽  
Author(s):  
Cheryl Holsworth ◽  
Susan Gallagher
Keyword(s):  
At Risk ◽  
Morbid Obesity ◽  
Weight Loss ◽  
Critical Care ◽  
Critically Ill ◽  
Metabolic Surgery ◽  
Chronic Conditions ◽  
Morbidly Obese ◽  
Care Needs ◽  
Bariatric Patients

Nearly 160 million Americans are overweight, obese, or morbidly obese. Morbid obesity and its numerous comorbidities are threats to a person’s health. Moreover, hospitalized individuals living with adiposity-based chronic conditions are at risk for certain immobility hazards. Many individuals who are morbidly obese look to metabolic surgery as a means for achieving sustainable weight loss. This article addresses critical care needs of people living with excess weight or weight maldistribution, along with specific needs of those undergoing metabolic surgery.

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