Comparison between Early Results of Laparoscopic Mini Gastric Bypass and Sleeve Gastrectomy regarding Weight Loss, Remission of Type II Diabetes Mellitus and Hypertension

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Awad El Kayal ◽  
Hossam Elsadek ◽  
Mohamed Ebrahim ◽  
Mohamed Salah El din Ebrahim El Ghamrawy

Abstract Background Bariatric Surgery leads to a dramatic improvement in morbid obesity and associated type 2 Diabetes Mellitus (T2DM) and hypertension. Objectives The aim of the study was to compare between early results of Laparoscopic Mini Gastric Bypass and Sleeve gastrectomy regarding excess weight loss, remission of Type II diabetes mellitus and hypertension. Patients and Methods Type of the study, retrospective study. study setting, Our study was carried out at The General Surgery Department Ain Shams University Hospitals. study period,. All cases were operated during the period February and march 2019. Follow up of patients 6 months after operation was done (retrospective study). Last follow up was done on September 2019. The study included 50 patients aged 18-60 years with Type II Diabetes Mellitus and hypertension of at least 6 months duration, BMI 35 65 kg/m2 for at least 5 years. Results In this study There was no statistical significant difference between studied groups as regard age,gender,and baseline clinical data. there was a statistical significant difference between patients in LMGB group as well as between patients in LGS group before and six months after surgery as regard weight in kg, BMI and HbA1C and.remission of hypertention (P value 0.000). there was high statistical significant difference between studied groups as regard percentage of change of weight and BMI(P value 0.000) However, there was no statistical significant difference between studied groups as regard percent of change of HbA1C. (P value 0.613),remission of T2DM.(p value 0.123 ) and control of hypertension. (p value 0.136 ). Further results and data could be reached on long-term follow up of patients involved in this study. Conclusion Patients receiving mini-gastric bypass had more advantageous indexes than patients receiving sleeve gastrectomy, such as higher six months EWL% (excess weight loss), higher T2DM remission rate and higher hypertension remission rate. Especially on long term follow up and that was proved by meta analysis of previous studies but on short term follow up there is no statistical singnificant difference between both studied groups except in percentage of change of weight and BMI. Mini-gastric bypass is simple, safe and more effective bariatric procedure than laparoscopic sleeve gastrectomy.

2019 ◽  
Vol 26 (12) ◽  
pp. 2040-2043
Author(s):  
Munir Ahmed ◽  
Abdul Hayee ◽  
Shahla Afsheen Memon ◽  
Ismail Salim Memon ◽  
Abdul Qayoom Memon

Objectives: To determine the frequency of diastolic dysfunction in patients presenting with type II Diabetes Mellitus. Study Design: Cross sectional study. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Period: From 01-01-2017 to 30-06-2017. Material & Methods: In this study the cases were selected via non probability consecutive sampling of both male and female gender with age more than 40 years having type II DM of at least more than 2 years were included. The cases suffering from type I DM, gestational DM and those with HTN, end stage kidney and liver failure were excluded. Trans thoracic echocardiography was done to label diastolic dysfunction and was labelled as yes when the E/A ratio was <0.8. The data was analysed using chi square test and p value less than 0.05 was taken as significant. Results: In this study, 100 cases of type II DM were included with mean age of 51.31±7.89 years at presentation. There were 61% males and 39% females. Diastolic dysfunction was observed in 53% of the cases. There was no significant difference in terms of gender where it affected 56.41% of females with p= 0.92. Diastolic dysfunction was more in cases that had duration of DM more than 3 years affecting 48 (70.58%) cases with p= 0.001 and it was also significantly high in cases that had BMI more than 30 where it was seen in 40 (70.17%) of cases with p= 0.001. Conclusion: Diastolic dysfunction seen in half of the cases suffering from type II DM and it is significantly high in cases that had duration of DM more than 3 years and BMI more than 30.


2017 ◽  
Vol 3 (2) ◽  
pp. 79-86
Author(s):  
Ravi Shankar Reddy

Background: Patients withType II diabetes mellitus are showed to affect the sensory, reflex and motor systems in distal extremities. Studies have examined the mechanosensitivity and vibration threshold (VT) in type II diabetes mellitus patients in the lower limb and compared it with normal individuals. There is scanty literature available in comparison of the VTin the upper limb in type II diabetes mellitus patients with non-diabetic individuals. Methods: Thirty type II diabetic individuals (age - 55.60 ± 9.79 years)and 30 asymptomatic individuals (age - 53.43±9.96) without diabetes mellitus participated in the study. Tester at the baseline for both the groups using a bioesthesiometer measured VT. Bioesthesiometer is capable of deriving a vibration of 100 Hz. Following VTevaluation at the baseline, the tester performed the ULNT1 for all the subjects. During the sequence of the ULNT1, VTwas measured at initial onset of pain (termed as P1) and short of maximum pain (P2) as experienced by the patient. Results:There was a statistical significant difference inVTbetween diabetic and non-diabetic group subjects. VTwas raised in the diabetic group at all the three levelsof evaluation (baseline, P1 and P2) compared to the non-diabetic group with a p value < 0.001. Conclusion: VT of the upper limb is higher in individuals with type II diabetes mellitus as compared to non-diabetic individuals.


Author(s):  
Fernando de BARROS ◽  
Mayara Galisse NEGRÃO ◽  
Giovana Galisse NEGRÃO

ABSTRACT Introduction: Bariatric surgery is currently the gold standard treatment for obesity. The two most accomplished surgeries are the Roux-en-Y gastric bypass and the sleeve gastrectomy, and controversies exist in which is better. Objective: To compare the two techniques in relation to weight loss with at least five years of follow-up. Methods: Search in Medline, PubMed, Embase, SciElo, Lilacs, Cochrane databases from 2001 (beginning of vertical gastrectomy) until 2018, using the following headings: “sleeve” or “sleeve gastrectomy” combined with “gastric bypass” or “Roux-en-Y gastric bypass”, “weight loss” and “clinical trial”. Criteria for inclusion of articles were patients aged between 18 and 65 years; clinical trial; comparison between the two techniques; minimum five-year follow-up; outcome with weight loss assessment. Results: The initial search identified 1940 articles, of which 185 publications were identified as clinical trials. One hundred and forty-one were excluded, 67 because they did not compare the two techniques, 57 not addressed weight loss and 17 were repeated articles. Thirty-four studies were retrieved for a more detailed analysis; 36 studies were excluded due to a follow-up of less than five years, and another compared the mini-gastric bypass. In total, seven studies were included in the systematic review, but there was no significant difference in three of them. Conclusion: The gastric bypass had a greater weight loss than the vertical gastrectomy in all the evaluated studies.


2019 ◽  
Vol 26 (06) ◽  
Author(s):  
Muslim Khahro ◽  
Qaimuddin Shaikh ◽  
Mehnaz Baloch ◽  
Surwaich Ali Channa ◽  
Arhama Shah

Objectives: To determine the frequency of dental caries in patients with type II diabetes mellitus. Study Design: Cross sectional study. Setting: Dental Department of Science of Dental Materials Department and Oral Pathology Department. Period: 6 months from October 2016 to February 2017. Material and Methods: All the diagnosed patients of type II diabetes mellitus either gender were selected for the study. Complete dental clinical examination and duration of diabetes were carried out. Dental caries were categorized as mild moderate and severe. Duration of diabetes was categorized as < years and > 5 years. All the data was recorded in the self-made proforma. Results: In this study total 58 patients were selected with history of type II diabetes mellitus; patient’s mean age was 46.36+5.34 years. Male gender was found in the majority 38(65.5%). Majority of the cases 37(63.8%) were found with low socioeconomic status. 26(44.8%) patients had history of type II diabetes mellitus less than 5 years, 32(55.2%) were with more than 5 years history of diabetes. 15.51% patients were without dental caries, 37.39% patients were with mild, 34.4% had moderate and 12.06% patients were with severe dental caries. No significant difference was found in severity of dental caries when compared with duration of diabetes p-value 0.93.  Conclusion: We concluded that there are a big prevalence dental caries among patients with type II diabetes mellitus, while severity of dental caries was insignificantly associated with duration of diabetes.


2019 ◽  
Vol 4 (2) ◽  
pp. 178
Author(s):  
Elis Anggeria ◽  
Patimah Sari Siregar

<p><em>Diabetes mellitus (DM) is a group of metabolic diseases characterized by high levels of glucose in the blood (hyperglycemia) that occurs due to impaired insulin secretion, decreased insulin action, or a result of both. Self-acceptance is the ability and desire of individuals to live with all the characteristics themselves against diabetes mellitus. This study aims to determine the effectiveness of diabetic ulcer treatment on self-acceptance of Type II Diabetes Mellitus patients at Asri Wound Care Center Medan. This study uses quantitative research methods with a quasi-experimental design through the one-group pretest-posttest design approach. The population in the study as many as 20 people, with sampling techniques using saturated sampling, the research sample amounted to 20 people. This study uses a nonparametric statistical test that is paired t-test. The results of research on self-acceptance of patients with type II diabetes mellitus before treatment of diabetic ulcers showed that the majority of self-acceptance was not good, and the self-acceptance of patients after treatment of diabetic ulcers obtained the majority of good self-acceptance. The effectiveness of diabetic ulcer treatment on self-acceptance of type II diabetes mellitus patients obtained significance value p-value = 0.00 (p-value &lt;0.05) then H0 was rejected. This means that there are differences in self-acceptance of type II Diabetes mellitus patients before and after diabetic ulcer treatment at Asri Wound Care Center Medan. Future researchers are expected to discuss more deeply about the factors that affect the self-acceptance of diabetes mellitus patients who are undergoing treatment for diabetic ulcers.</em></p>


2017 ◽  
Vol 2 (2) ◽  
pp. 26-34
Author(s):  
Hridaya Parajuli ◽  
Jyotsna Shakya ◽  
Bashu Dev Pardhe ◽  
Puspa Raj Khanal ◽  
Narayan Prasad Parajuli ◽  
...  

Background: Hyperuricemia is associated with type 2 diabetes, which is a metabolic disorder of multiple etiologies resulting from defects in insulin action. The present study wascarried out to look for any association between uric acid and Type II Diabetes Mellitus and also status of triacylglycerol level among those patients.Methods: The blood samples were collected 100 diabetic and 100 non-diabetic individuals in the department of biochemistry and then analyzed for estimation of blood glucose, Uric Acid and Triacylglycerol level.Results: The average level of serum uric acid in diabetic patients was higher (5.706±1.617) in comparison to non diabetic subjects (4.322±0.784) with statistically significant difference (p≤0.05). For female the result indicate there was a positive correlation between (FBS and triglycerides) and (triglycerides and uric acids) which was statistically significant (r =-0.465, n = 41, p = 0.002) and(r =-0.370, n = 41, p = 0.017) respectively.Conclusions: This study documents that hyperuricemia is associated with type 2 diabetes mellitus. Furthermore, the serum triacylglycerol and serum uric acid is also found to be associated risk factors for diabetic complications. Hence, timely diagnosis and management of diabetes is vital to control the complications related to diabetes.Ann. Clin. Chem. Lab. Med. 2016:2(1); 26-34


2017 ◽  
Vol 12 (05) ◽  
pp. 372-385
Author(s):  
Matthias Weck

In den letzten Jahren wurden die Ergebnisse randomisierter kontrollierter Studien publiziert, die im 5-Jahres-Verlauf die metabolischen Effekte der bariatrischen Chirurgie mit konventionellen Formen der Gewichtsreduktion vergleichen. Diese Studien zeigen unisono, dass die bariatrische Chirurgie hinsichtlich der Besserung der diabetischen Stoffwechsellage den konventionellen Behandlungsformen signifikant überlegen ist. Die Diabetesremissionsraten variieren abhängig von Ausgangsparametern, Operationsmethode und Follow-up-Dauer zwischen 95 und 23 %.Ist Diabetes heilbar durch bariatrische Chirurgie? Die klare Antwort muss lauten: Nein, aberInsofern ist die bariatrische Chirurgie in Form von Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Sleeve Gastrectomy (LSG) und den neueren Verfahren wie Omega Loop Bypass („Mini-Bypass“) oder biliopankreatische Diversion (BPD) eine wirkungsvolle therapeutische Option in der Behandlung des Diabetes mellitus Typ 2 und verringert offenbar auch das Risiko des Auftretens von mikrovaskulären Diabetesfolgekomplikationen. Je früher im Krankheitsverlauf die bariatrische Chirurgie SSherangezogen wird, desto effektiver scheinen diese Verfahren zu sein.Welche der Operationen für Patienten mit Typ-2-Diabetes am besten geeignet ist, ist derzeit nicht definitiv entschieden. Der RYGB scheint etwas effektiver zu sein. Die Verfahren der bariatrischen Chirurgie gehören in das Spektrum der differenzialtherapeutischen Überlegungen insbesondere bei adipösen Patienten mit Typ-2-Diabetes mit einem BMI > 35 kg/m².Die Mechanismen der Verbesserung der diabetischen Stoffwechsellage durch bariatrische Operationen werden anhand der aktuellen Literatur detailliert beschrieben. Die Indikationen, Kontraindikationen, Komplikationen und Therapiealgorithmen der bariatrischen Chirurgie bei Typ-2-Diabetes sind in den entsprechenden Leitlinien ausführlich dargestellt und nicht Gegenstand dieser Publikation.


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