scholarly journals Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity: Comparison of Gastric Bypass, Sleeve Gastrectomy, and Usual Care

2021 ◽  
Author(s):  
Ali Aminian ◽  
Rickesha Wilson ◽  
Alexander Zajichek ◽  
Chao Tu ◽  
Kathy E. Wolski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Surgical Procedures ◽  
Cumulative Incidence ◽  
Cox Regression ◽  
Cleveland Clinic ◽  
Major Adverse Cardiovascular Events ◽  
Cox Regression Analysis

<p><b>Objective:</b> To determine which one of the two most common metabolic surgical procedures is associated with greater reduction in risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2DM) and obesity.</p> <p><b> </b></p> <p><b>Research Design and Methods:</b> A total of 13,490 patients including 1,362 Roux-en-Y gastric bypass (RYGB), 693 sleeve gastrectomy (SG), and 11,435 matched non-surgical patients with T2DM and obesity who received their care at the Cleveland Clinic (1998-2017) were analyzed with follow-up through December 2018. Multivariable Cox regression analysis estimated time to incident extended MACE, defined as first occurrence of coronary artery events, cerebrovascular events, heart failure, nephropathy, atrial fibrillation, and all-cause mortality. </p> <p><b> </b></p> <p><b>Results:</b> The cumulative incidence of the primary endpoint at 5 years was 13.7% [95%CI 11.4-15.9] in the RYGB groups and 24.7% [95%CI 19.0-30.0] in the SG group with an adjusted HR of 0.77 [95%CI 0.60 to 0.98], p=0.04. Of the 6 individual endpoints, RYGB was associated with a significantly lower cumulative incidence of nephropathy at 5 years compared with SG (2.8% vs 8.3%, respectively); HR 0.47 [95%CI 0.28-0.79], p=0.005. Furthermore, RYGB was associated with a greater reduction in body weight, glycated hemoglobin, and use of medications to treat diabetes and cardiovascular diseases. Five years after RYGB, patients required more upper endoscopy (45.8% vs 35.6%, p<0.001) and abdominal surgical procedures (10.8% vs 5.4%, p=0.001) compared with SG. </p> <p><b> </b></p> <p><b>Conclusion:</b> In patients with obesity and T2DM, RYGB may be associated with greater weight loss, better diabetes control, and lower risk of MACE and nephropathy compared with SG.</p>

scholarly journals Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity: Comparison of Gastric Bypass, Sleeve Gastrectomy, and Usual Care

2021 ◽  
Author(s):  
Ali Aminian ◽  
Rickesha Wilson ◽  
Alexander Zajichek ◽  
Chao Tu ◽  
Kathy E. Wolski ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Surgical Procedures ◽  
Cumulative Incidence ◽  
Cox Regression ◽  
Cleveland Clinic ◽  
Major Adverse Cardiovascular Events ◽  
Cox Regression Analysis

<p><b>Objective:</b> To determine which one of the two most common metabolic surgical procedures is associated with greater reduction in risk of major adverse cardiovascular events (MACE) in patients with type 2 diabetes (T2DM) and obesity.</p> <p><b> </b></p> <p><b>Research Design and Methods:</b> A total of 13,490 patients including 1,362 Roux-en-Y gastric bypass (RYGB), 693 sleeve gastrectomy (SG), and 11,435 matched non-surgical patients with T2DM and obesity who received their care at the Cleveland Clinic (1998-2017) were analyzed with follow-up through December 2018. Multivariable Cox regression analysis estimated time to incident extended MACE, defined as first occurrence of coronary artery events, cerebrovascular events, heart failure, nephropathy, atrial fibrillation, and all-cause mortality. </p> <p><b> </b></p> <p><b>Results:</b> The cumulative incidence of the primary endpoint at 5 years was 13.7% [95%CI 11.4-15.9] in the RYGB groups and 24.7% [95%CI 19.0-30.0] in the SG group with an adjusted HR of 0.77 [95%CI 0.60 to 0.98], p=0.04. Of the 6 individual endpoints, RYGB was associated with a significantly lower cumulative incidence of nephropathy at 5 years compared with SG (2.8% vs 8.3%, respectively); HR 0.47 [95%CI 0.28-0.79], p=0.005. Furthermore, RYGB was associated with a greater reduction in body weight, glycated hemoglobin, and use of medications to treat diabetes and cardiovascular diseases. Five years after RYGB, patients required more upper endoscopy (45.8% vs 35.6%, p<0.001) and abdominal surgical procedures (10.8% vs 5.4%, p=0.001) compared with SG. </p> <p><b> </b></p> <p><b>Conclusion:</b> In patients with obesity and T2DM, RYGB may be associated with greater weight loss, better diabetes control, and lower risk of MACE and nephropathy compared with SG.</p>

78-OR: Glycaemia, Beta-Cell Function, and Incretin Hormones Post-OGTT One Year after Gastric Bypass and Sleeve Gastrectomy in Patients with Morbid Obesity and Type 2 Diabetes: An RCT (Oseberg Study)

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 78-OR
Author(s):  
FARHAT FATIMA ◽  
JØRAN HJELMESÆTH ◽  
KARE I. BIRKELAND ◽  
HANNE L. GULSETH ◽  
JENS K. HERTEL ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Morbid Obesity ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Beta Cell ◽  
Beta Cell Function ◽  
Cell Function ◽  
Incretin Hormones ◽  
One Year

scholarly journals Reported appetite, taste and smell changes following Roux-en-Y gastric bypass and sleeve gastrectomy: Effect of gender, type 2 diabetes and relationship to post-operative weight loss

Appetite ◽  
2016 ◽  
Vol 107 ◽  
pp. 93-105 ◽  
Author(s):  
Janine M. Makaronidis ◽  
Sabrina Neilson ◽  
Wui-Hang Cheung ◽  
Urszula Tymoszuk ◽  
Andrea Pucci ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Weight Loss ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Taste And Smell ◽  
Gender Type

scholarly journals Sleeve Gastrectomy Versus Mini-gastric Bypass in Type 2 Diabetes

2019 ◽  
Vol 4 (2) ◽  
pp. 109-115
Author(s):  
M.A. Mansour ◽  
R.S. Salama ◽  
M.A. Elbegawy ◽  
M.E. Ahmed
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Mini Gastric Bypass

Increased Bile Acids and FGF19 After Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Correlate with Improvement in Type 2 Diabetes in a Randomized Trial

2018 ◽  
Vol 28 (9) ◽  
pp. 2672-2686 ◽  
Author(s):  
Reza Nemati ◽  
Jun Lu ◽  
Dech Dokpuang ◽  
Michael Booth ◽  
Lindsay D. Plank ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Randomized Trial ◽  
Bile Acids

scholarly journals Correlation between markers of renal function and sight-threatening diabetic retinopathy in type 2 diabetes: a longitudinal study in an Indian clinic population

2020 ◽  
Vol 8 (1) ◽  
pp. e001325 ◽  
Author(s):  
Ramachandran Rajalakshmi ◽  
Coimbatore Subramanian Shanthi Rani ◽  
Ulagamathesan Venkatesan ◽  
Ranjit Unnikrishnan ◽  
Ranjit Mohan Anjana ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Diabetic Retinopathy ◽  
Serum Creatinine ◽  
Cox Regression ◽  
Tertiary Care ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
New Onset

IntroductionPrevious epidemiological studies have reported on the prevalence of diabetic kidney disease (DKD) and diabetic retinopathy (DR) from India. The aim of this study is to evaluate the effect of DKD on the development of new-onset DR and sight-threatening diabetic retinopathy (STDR) in Asian Indians with type 2 diabetes (T2D).Research design and methodsThe study was done on anonymized electronic medical record data of people with T2D who had undergone screening for DR and renal work-up as part of routine follow-up at a tertiary care diabetes center in Chennai, South India. The baseline data retrieved included clinical and biochemical parameters including renal profiles (serum creatinine, estimated glomerular filtration rate (eGFR) and albuminuria). Grading of DR was performed using the modified Early Treatment Diabetic Retinopathy Study grading system. STDR was defined as the presence of proliferative diabetic retinopathy (PDR) and/or diabetic macular edema. DKD was defined by the presence of albuminuria (≥30 µg/mg) and/or reduction in eGFR (<60 mL/min/1.73 m2). Cox regression analysis was used to evaluate the hazard ratio (HR) for DR and STDR.ResultsData of 19 909 individuals with T2D (mean age 59.6±10.2 years, mean duration of diabetes 11.1±12.1 years, 66.1% male) were analyzed. At baseline, DR was present in 7818 individuals (39.3%), of whom 2249 (11.3%) had STDR. During the mean follow-up period of 3.9±1.9 years, 2140 (17.7%) developed new-onset DR and 980 individuals with non-proliferative DR (NPDR) at baseline progressed to STDR. Higher serum creatinine (HR 1.5, 95% CI 1.3 to 1.7; p<0.0001), eGFR <30 mL/min/1.73 m2 (HR 4.9, 95% CI 2.9 to 8.2; p<0.0001) and presence of macroalbuminuria >300 µg/mg (HR 3.0, 95% CI 2.4 to 3.8; p<0.0001) at baseline were associated with increased risk of progression to STDR.ConclusionsDKD at baseline is a risk factor for progression to STDR. Physicians should promptly refer their patients with DKD to ophthalmologists for timely detection and management of STDR.

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