One anastomosis gastric bypass: a way to normalize insulin secretion in patients with obesity and type 2 diabetes mellitus, regardless of clinically significant weight loss

Background/purpose: Few studies evaluating the mid-term outcome of type 2 diabetes mellitus (t2DM) after Roux-en-Y Gastric Bypass (RYGB) are available at this time. The aim of this study is to assess mid-term impact of RYGB on t2DM regarding the need for anti-diabetic medication, biochemical response and associated weight loss. Methods: Retrospective analysis of prospectively collected data was performed for patients suffering from t2DM who underwent RYGB between 1/1/2000 and 1/1/2015. Patients were divided into 2 groups according to the preoperative need for insulin. Study parameters included Body Mass Index (BMI), %Excess Weight Loss (%EWL), Hemoglobin A1c (HbA1c) and fasting glucose at 1, 3, 6 and 10-year intervals after surgery. Results: 140 patients (97 women, 43 men) were included. Mean preoperative BMI was 42.8 kg/m² (range 35.0 - 75.0). Mean duration of t2DM before RYGB was 5,7 years (range 0,2 - 30,1). Preoperative need for anti-diabetic medication was seen in 102 patients (72,8%) of which 49 (48,0%) were insulin-dependent (ID-group). Mean postoperative follow-up was 5,9 years (range 0,1 – 14,5). Remission of t2DM (fasting glucose < 126mg/dl and a HbA1c < 6.5% without the need of anti-diabetic medication for at least 6 months) was present in both groups: 46,7%, 48,1%, 45,0%, 50,0% (ID-group) and 59,1%, 62,2%, 53,3%, 33,3% (insulin independent patients) at respectively 1, 3, 6 and 10-years follow up. No significant correlation was proven between remission and %EWL. Conclusions: Bariatric surgery is useful in the mid-term management of uncontrolled t2DM.

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

Galen Medical Journal ◽

10.31661/gmj.v3i3.163 ◽

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.

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Type 2 diabetes mellitus status in obese patients following sleeve gastrectomy or one anastomosis gastric bypass

Scientific Reports ◽

10.1038/s41598-021-83807-8 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Gavriella Zoi Vrakopoulou ◽

Charalampos Theodoropoulos ◽

Vasileios Kalles ◽

George Zografos ◽

Konstantinos Almpanopoulos

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Weight Loss ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Obese Patients ◽

Group A ◽

Insulin Dependent ◽

Group B

AbstractThis study aims to compare sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB) in terms of remission of type 2 diabetes mellitus (T2DM) in obese patients. All T2DM patients were followed-up for at least 36 months. The primary outcome was remission of T2DM. Secondary endpoints included weight reduction and the procedure’s impact on quality of life. In total, 53/1177 morbidly obese patients who underwent SG (Group A, n = 28) or OAGB (Group B, n = 25) had T2DM. Preoperatively, the mean Body Mass Index (BMI) values were 52.2 ± 8.5 kg/m2 and 52.9 ± 10.9 kg/m2 for Group A and Group B, respectively. Six patients in Group A were insulin dependent, while 8 were insulin dependent in Group B. After 36 months, diabetes remission was achieved by only 10 patients (35.7%) in Group A. However, in Group B, 22 patients (88%) remained off antidiabetic agents (p < 0.0001), with ΔHbA1c (%) reaching 1.4 ± 1.5% in Group A and 2.7 ± 2.1% in Group B (p = 0.02). Excess weight loss% (%EWL) was again significantly different between the two groups (MA = 79.8 ± 14.5%, MB = 93.3 ± 16.0%, p = 0.003). OAGB is more effective in improving glycaemic control and %EWL, with almost immediate resolution of diabetes, as well as long-term weight loss.

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Efficacy of Laparoscopic Mini Gastric Bypass for Obesity and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis

Gastroenterology Research and Practice ◽

10.1155/2015/152852 ◽

2015 ◽

Vol 2015 ◽

pp. 1-13 ◽

Cited By ~ 44

Author(s):

Yingjun Quan ◽

Ao Huang ◽

Min Ye ◽

Ming Xu ◽

Biao Zhuang ◽

...

Keyword(s):

Diabetes Mellitus ◽

Systematic Review ◽

Type 2 Diabetes ◽

Weight Loss ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Literature Search ◽

Meta Analysis ◽

Mini Gastric Bypass

Background. Controversies on the utility of laparoscopic mini gastric bypass (LMGB) in weight loss and type 2 diabetes mellitus (T2DM) control still exist.Methods. We conducted a comprehensive literature search of PubMed, EMBASE, and Cochrane Library. Review Manager was used to perform the meta-analysis and the weighted mean difference (WMD) and/or odds ratio with 95% confidence interval (95% CI) were used to evaluate the overall size effect.Results. The literature search identified 16 studies for systematic review and 15 articles for meta-analysis. Compared with LAGB, LSG, and LRYGB, LMGB showed significant weight loss [WMD, −6.58 (95% CI, −9.37, −3.79),P<0.01(LAGB); 2.86 (95% CI, 1.40, 5.83),P=0.004(LSG); 10.33 (95% CI, 4.30, 16.36),P<0.01(LRYGB)] and comparable/higher T2DM remission results [86.2% versus 55.6%,P=0.06(LAGB); 89.1% versus 76.3%,P=0.004(LAGB); 93.4% versus 77.6%,P=0.006(LAGB)]; LMGB also had shorter learning curve and less operation time than LRYGB [WMD, −35.2 (95% CI, −46.94, −23.46)].Conclusions. LMGB appeared to be effective in weight loss and T2DM remission and noninferior to other bariatric surgeries. However, clinical utility of LMGB needs to be further validated by future prospective randomized controlled trials.

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One Anastomosis Gastric Bypass/Minigastric Bypass in Patients with BMI < 35 kg/m2 and Type 2 Diabetes Mellitus: Preliminary Report

Obesity Surgery ◽

10.1007/s11695-019-04071-4 ◽

2019 ◽

Vol 29 (12) ◽

pp. 3987-3991 ◽

Cited By ~ 1

Author(s):

Salvador Navarrete Aulestia ◽

José Luis Leyba ◽

Salvador Navarrete Llopis ◽

Viviana Pulgar

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Preliminary Report ◽

One Anastomosis Gastric Bypass

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The Short-Term Effects of Transit Bipartition with Sleeve Gastrectomy and Distal-Roux-en-Y Gastric Bypass on Glycemic Control, Weight Loss, and Nutritional Status in Morbidly Obese and Type 2 Diabetes Mellitus Patients

Obesity Surgery ◽

10.1007/s11695-020-05212-w ◽

2021 ◽

Author(s):

Ilhan Ece ◽

Huseyin Yilmaz ◽

Serdar Yormaz ◽

Bayram Çolak ◽

Akin Calisir ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Weight Loss ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Sleeve Gastrectomy ◽

Morbidly Obese ◽

Short Term ◽

Transit Bipartition

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TYPE 2 DIABETES MELLITUS REMISSION AND ITS PREDICTION AFTER TWO-STAGE SURGICAL TREATMENT OF PATIENTS WITH MORBID OBESITY

Wiadomości Lekarskie ◽

10.36740/wlek201905102 ◽

2019 ◽

Vol 72 (5) ◽

pp. 739-743

Author(s):

Oleksandr Yu. Ioffe ◽

Mykola S. Kryvopustov ◽

Yuri A. Dibrova ◽

Yuri P. Tsiura

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Morbid Obesity ◽

Weight Loss ◽

Type 2 Diabetes Mellitus ◽

Surgical Treatment ◽

Two Stage ◽

C Peptide ◽

Peptide Level

Introduction: Morbid obesity (MO) has a significant impact on mortality, health and quality of life of patients. Type 2 diabetes mellitus (T2DM) is a common comorbidity in patients with MO. The aim is to study T2DM remission and to develop a prediction model for T2DM remission after two-stage surgical treatment of patients with MO. Materials and methods: The study included 97 patients with MO. The mean BMI was 68.08 (95% CI: 66.45 - 69.71) kg/m2. 70 (72,2%) patients with MO were diagnosed with T2DM. The first stage of treatment for the main group (n=60) included the IGB placement, for the control group (n=37) - conservative therapy. In the second stage of treatment the patients underwent bariatric surgery. The study addresses such indicators as BMI, percentage of weight loss, percentage of excess weight loss, ASA physical status class, fasting glucose level, HbA1c, C-peptide. Results: Two-stage treatment of morbidly obese patients with T2DM promotes complete T2DM remission in 68.1% of patients. The risk prediction model for failure to achieve complete T2DM remission 12 months after LRYGB based on a baseline C-peptide level has a high predictive value, AUC = 0.84 (95% CI: 0.69-0.93), OR = 0.23 ( 95% CI: 0.08-0.67). Conclusions: Two-stage treatment of patients with MO promotes improvement of carbohydrate metabolism indicators. With a C-peptide level > 3.7 ng/ml, prediction of complete T2DM remission 12 months after Laparoscopic Roux-en-Y Gastric Bypass is favorable.

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Echinops Spp. Polysaccharide B Ameliorates Metabolic Abnormalities in a Rat Model of Type 2 Diabetes Mellitus

Current Topics in Nutraceutical Research ◽

10.37290/ctnr2641-452x.19:106-114 ◽

2020 ◽

Vol 19 (1) ◽

pp. 106-114

Author(s):

Guang Hao ◽

Xiaoyu Ma ◽

Mengru Jiang ◽

Zhenzhen Gao ◽

Ying Yang

Keyword(s):

Diabetes Mellitus ◽

Insulin Resistance ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Insulin Secretion ◽

Insulin Receptor ◽

Skeletal Muscles ◽

Insulin Receptor Substrate ◽

Sprague Dawley

This study examined the in vivo effects of Echinops spp. polysaccharide B on type 2 diabetes mellitus in Sprague-Dawley rats. We constructed a type 2 diabetes mellitus Sprague-Dawley rat models by feeding a high-fat and high-sugar diet plus intraperitoneal injection of a small dose of streptozotocin. Using this diabetic rat model, different doses of Echinops polysaccharide B were administered orally for seven weeks. Groups receiving Xiaoke pill and metformin served as positive controls. The results showed that Echinops polysaccharide B treatment normalized the weight and blood sugar levels in the type 2 diabetes mellitus rats, increased muscle and liver glycogen content, improved glucose tolerance, increased insulin secretion, and reduced glucagon and insulin resistance indices. More importantly, Echinops polysaccharide B treatment upregulated the expression of insulin receptor in the liver, skeletal muscles, and pancreas, and significantly improved the expression levels of insulin receptor substrate-2 protein in the liver and pancreas, as well as it increased insulin receptor substrate-1 expression in skeletal muscles. These two proteins play crucial roles in increasing insulin secretion and in controlling type 2 diabetes mellitus. The findings of the present study suggest that Echinops polysaccharide B could improve the status of diabetes in type 2 diabetes mellitus rats, which may be achieved by improving insulin resistance. Our study provides a new insight into the development of a natural drug for the control of type 2 diabetes mellitus.

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