Faculty Opinions recommendation of Effects of Laparoscopic Roux-en-Y Gastric Bypass on Chinese Type 2 Diabetes Mellitus Patients with Different Levels of Obesity: Outcomes After 3 Years' Follow-Up.

Author(s):  
Naji Abumrad
2021 ◽  
Vol 108 (Supplement_4) ◽  
Author(s):  
J Süsstrunk ◽  
L Wartmann ◽  
D Mattiello ◽  
T Köstler ◽  
U Zingg

Abstract Objective Marginal ulcer (MU) is a serious complication after Roux-en-Y gastric bypass (RYGB) procedures. This study reports the incidence, risk factors and treatment outcomes of symptomatic and incidentally, at routine endoscopy diagnosed, MU. Methods All patients undergoing RYGB procedures between 2013 and 2018 at a single center were included. Upper endoscopy was performed in case of symptoms and/or routinely 2 and 5 years postoperatively. Results 568 patients (83.3% female) underwent RYGB procedure with a median age of 40 years and median initial body mass index of 41 kg/m2. Median time to follow-up was 2.99 years. Routine 2- and 5-year upper endoscopy was performed in 256 (55.3%) and 65 (38.0%) eligible patients, respectively. In 86 (15.1%) patients, MU was diagnosed at a median time of 14.2 months (4.58 – 26.2) postoperatively and 24.4% of patients with MU were asymptomatic. 76.7% of MUs were located on the side of the Roux-limb. 88.4% of MUs were treated conservatively; re-operation was necessary in 10 (11.6%) patients. Smoking and type 2 diabetes mellitus were the only independent risk factors for MU development in multivariate analysis with a hazard ratio of 2.65 and 1.18 (HbA1c per unit >6.0), respectively. Conclusion MU is a common complication after gastric bypass surgery with 25% of patients being asymptomatic. Follow-up routine endoscopy is recommended for early MU detection and subsequent accurate therapy, especially in patients with the independent risk factors smoking and type 2 diabetes mellitus.


2017 ◽  
Vol 7 (2) ◽  
pp. 40
Author(s):  
Ben Gys ◽  
Filip Haenen ◽  
Tobie Gys ◽  
Thierry Lafullarde

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.


2014 ◽  
Vol 84 (1-2) ◽  
pp. 27-34 ◽  
Author(s):  
Nasser M. Al-Daghri ◽  
Khalid M. Alkharfy ◽  
Nasiruddin Khan ◽  
Hanan A. Alfawaz ◽  
Abdulrahman S. Al-Ajlan ◽  
...  

The aim of our study was to evaluate the effects of vitamin D supplementation on circulating levels of magnesium and selenium in patients with type 2 diabetes mellitus (T2DM). A total of 126 adult Saudi patients (55 men and 71 women, mean age 53.6 ± 10.7 years) with controlled T2DM were randomly recruited for the study. All subjects were given vitamin D3 tablets (2000 IU/day) for six months. Follow-up mean concentrations of serum 25-hydroxyvitamin D [25-(OH) vitamin D] significantly increased in both men (34.1 ± 12.4 to 57.8 ± 17.0 nmol/L) and women (35.7 ± 13.5 to 60.1 ± 18.5 nmol/L, p < 0.001), while levels of parathyroid hormone (PTH) decreased significantly in both men (1.6 ± 0.17 to 0.96 ± 0.10 pmol/L, p = 0.003) and women (1.6 ± 0.17 to 1.0 ± 0.14 pmol/L, p = 0.02). In addition, there was a significant increase in serum levels of selenium and magnesium in men and women (p-values < 0.001 and 0.04, respectively) after follow-up. In women, a significant correlation was observed between delta change (variables at six months-variable at baseline) of serum magnesium versus high-density lipoprotein (HDL)-cholesterol (r = 0.36, p = 0.006) and fasting glucose (r = - 0.33, p = 0.01). In men, there was a significant correlation between serum selenium and triglycerides (r = 0.32, p = 0.04). Vitamin D supplementation improves serum concentrations of magnesium and selenium in a gender-dependent manner, which in turn could affect several cardiometabolic parameters such as glucose and lipids.


2012 ◽  
Author(s):  
Lihua Wu ◽  
Angus Forbes ◽  
Peter D Griffiths ◽  
Alison While

2021 ◽  
pp. 193229682110288
Author(s):  
Lynn E. Kassel ◽  
Jessica J. Berei ◽  
Jamie M. Pitlick ◽  
Joel E. Rand

Bariatric surgery is a known and effective treatment for type 2 diabetes mellitus. Patients with type 1 diabetes mellitus and exogenous insulin-requiring type 2 diabetes mellitus require adjusted insulin dosing after surgery to avoid hypoglycemia. This review describes insulin dose adjustments following a variety of bariatric procedures. After searching the available literature and assessing for eligibility, 8 articles were included. The Johns Hopkins Research Evidence Appraisal Tool for literature appraisal was used. The results of this review reveal insulin dose adjustment varies based upon surgical procedure type and time of follow-up from the procedure.


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