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.

Diverted sleeve gastrectomy with ileal transposition in overweight, obese, and morbidly obese patients with type 2 diabetes: results of 1-year follow-up

2016 ◽  
Vol 12 (3) ◽  
pp. 541-549 ◽  
Author(s):  
Alper Celik ◽  
Eylem Cagiltay ◽  
Surendra Ugale ◽  
Muharrem Asci ◽  
Bahri Onur Celik ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Ileal Transposition

Prevalence of Undiagnosed and Inadequately Treated Type 2 Diabetes Mellitus, Hypertension, and Dyslipidemia in Morbidly Obese Patients Who Present for Bariatric Surgery

2014 ◽  
Vol 24 (6) ◽  
pp. 927-935 ◽  
Author(s):  
Rouzbeh Mostaedi ◽  
Denise E. Lackey ◽  
Sean H. Adams ◽  
Stephen A. Dada ◽  
Zahid A. Hoda ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Type 2 Diabetes Mellitus ◽  
Morbidly Obese ◽  
Obese Patients

Laparoscopic sleeve gastrectomy: Effect on long-term remission for morbidly obese patients with type 2 diabetes at 5-year follow up

Surgery ◽  
2017 ◽  
Vol 162 (4) ◽  
pp. 857-862 ◽  
Author(s):  
Marius Nedelcu ◽  
Marcelo Loureiro ◽  
Mehdi Skalli ◽  
Florence Galtier ◽  
Audrey Jaussent ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Update on the Mechanisms Facilitating Weight Loss and Resolution of Type 2 Diabetes Following Bariatric Surgery

2012 ◽  
Vol 19 (4) ◽  
pp. 425-432
Author(s):  
Cornelia Zetu ◽  
Rubin Munteanu ◽  
Anca Frunză ◽  
Constantin Ionescu-Tîrgovişte
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Body Mass Index ◽  
Weight Loss ◽  
Morbidly Obese ◽  
Obese Patients ◽  
Glucose Profiles ◽  
Obese Subjects

AbstractThe prevalence of type 2 diabetes mellitus (T2DM) and obesity is steadily increasingworldwide. To fight the twin pandemics of obesity and T2DM, clinicians need everytool they can get. Major, durable weight loss is uncommon with medical andbehavioral approaches; many diabetes drugs promote weight gain, while using themto obtain better blood glucose profiles increases the risk of hypoglycemia. Bariatricsurgery seems to be the most effective method for promoting major and durableweight loss in obese subjects, leading also to ameliorations of obesity-associated comorbidities,especially T2DM. Currently, indications for bariatric surgery includemorbidly obese patients or patients with a body mass index (BMI) >35 withsignificant co-morbidities. Currently, bariatric surgery (also referred to as“metabolic surgery”) is advocated for the treatment of T2DM even in overweightsubjects who do not meet the current BMI criteria. This review examines the currentevidence regarding the mechanisms of T2DM resolution following bariatric surgery.

scholarly journals Impact of bariatric surgery on type 2 diabetes in morbidly obese patients and its correlation with pre-operative prediction scores

2020 ◽  
Vol 0 (0) ◽  
pp. 0
Author(s):  
Sandeep Aggarwal ◽  
Mehul Gupta ◽  
Amit Bhambri ◽  
Vitish Singla ◽  
Rachna Chaudhary
Keyword(s):  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Morbidly Obese ◽  
Obese Patients

scholarly journals Effects of Laparoscopic Roux-en-Y Gastric Bypass on Anthropometric Characteristics, Hypertension, Type 2 Diabetes Mellitus and Metabolic Syndrome: An Iranian Experience

2014 ◽  
Vol 3 (3) ◽  
pp. 167-75
Author(s):  
Morteza Ghoghaei ◽  
Elias Khajeh ◽  
Foad Taghdiri ◽  
Mohammad Mahdi Zamani ◽  
Soudeh Taghdiri ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Type 2 Diabetes Mellitus ◽  
Morbidly Obese ◽  
Obese Patients

 Background: Surgically induced weight loss is a treatment option for the management of obesity and the related common disorders. This study evaluated the beneficial effects of bariatric surgery on metabolic profile and the prevalence of metabolic syndrome (MetS) among Iranian patients.Materials and Methods: A prospective observational study was performed on 26 morbidly obese patients scheduled for bariatric surgery, using laparoscopic Roux-en-Y gastric bypass (LRYGB). The parameters of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemia, MetS prevalence, and anthropometric measurements of Iranian patients, were recorded, at the preoperative visit and in follow-ups. The follow-up was performed for a median of 12 months, and the change in MetS prevalence and its componnts were assesed.Results: LRYGB induced a mean weight loss of 69.0±21.2%, after 12 months. Preoperative MetS was diagnosed in 21 patients (84%) and decreased to 6 patients (24%) after LRYGB (P=0.001). Likewise, the prevalence of hypertension was significantly decreased from 76% (pre-LRYGB values) to 20% (post-LRYGB values) (P=0.001). The prevalence of T2DM was also decreased from 20% to 8% (P=0.5).Conclusion: According to our results, RYGB produced a rapid and significant weight loss and improvement in hypertension and MetS within one year but there was a controversy about the improvement of T2DM, in Iranian morbidly obese patients.

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.

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