O efeito em curto prazo do bypass gástrico sobre pacientes obesos diabéticos

Stoll, Aluisio; Silva, Jean Carl; Bahten, Luiz Carlos Von; Gugelmin, Giovana; Vedan, André Berton; Souza, Bárbara Vicente de

doi:10.1590/s0100-69912013000100003

Cited by 6 publications

(10 citation statements)

References 29 publications

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“…A variety of treatment options exist for the management of insulin resistance, including a multidisciplinary clinical approach designed to promote weight loss, pharmacological therapies, and bariatric and metabolic surgical techniques 15 , 17 - 18 . Ileal transposition involves the removal of a segment of the distal ileum and its insertion into the proximal small intestine, a procedure that promotes early satiety and exerts beneficial effects on glucose metabolism and weight loss.…”

Section: Introductionmentioning

confidence: 99%

Immunological Evaluation of Patients With Type 2 Diabetes Mellitus Submitted to Metabolic Surgery

Borges

Terra

Takeuti

et al. 2015

ABCD, arq. bras. cir. dig.

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Background : Immunological and inflammatory mechanisms play a key role in the development and progression of type 2 diabetes mellitus. Aim : To raise the hypothesis that alterations in immunological parameters occur after duodenojejunal bypass surgery combined with ileal interposition without gastrectomy, and influences the insulin metabolism of betacells.Methods : Seventeen patients with type 2 diabetes mellitus under clinical management were submitted to surgery and blood samples were collected before and six months after surgery for evaluation of the serum profile of proinflammatory (IFN-γ, TNF-α, IL-17A) and anti-inflammatory cytokines (IL-4, IL-10). In addition, anthropometric measures, glucose levels and insulin use were evaluated in each patient. Results : No changes in the expression pattern of proinflammatory cytokines were observed before and after surgery. In contrast, there was a significant decrease in IL-10 expression, which coincided with a reduction in the daily insulin dose, glycemic index, and BMI of the patients. Early presentation of food to the ileum may have induced the production of incretins such as GLP-1 and PYY which, together with glycemic control, contributed to weight loss, diabetes remission and the consequent good surgical prognosis of these patients. In addition, the control of metabolic syndrome was responsible for the reduction of IL-10 expression in these patients. Conclusion : These findings suggest the presence of low-grade inflammation in these patients during the postoperative period, certainly as a result of adequate glycemic control and absence of obesity, contributing to a good outcome of surgery.

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Section: Introductionmentioning

confidence: 99%

Immunological Evaluation of Patients With Type 2 Diabetes Mellitus Submitted to Metabolic Surgery

Borges

Terra

Takeuti

et al. 2015

ABCD, arq. bras. cir. dig.

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“…Roux-en-Y gastric bypass (RYGB) has a rapid and drastic effect in type 2 diabetic patients, many of whom show complete remission within days of the procedure [1, 2]. A number of studies have demonstrated that gut hormones, especially GLP-1, may play a pivotal role in the regulation of glucose metabolism in response to this surgery [3, 4].…”

Section: Introductionmentioning

confidence: 99%

The Improvement of Hyperglycemia after RYGB Surgery in Diabetic Rats Is Related to Elevated Hypothalamus GLP-1 Receptor Expression

Zynat

Guo

et al. 2016

International Journal of Endocrinology

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Objectives. This study aimed to explore the expression of GLP-1 receptor in hypothalamus and gastrointestinal tissues after Roux-en-Y gastric bypass (RYGB) surgery in diabetic rats. Methods. Male 12-week-old Wistar rats (control) and Goto-Kakizaki rats (diabetic) were randomly divided into two groups, respectively: control sham surgery group (C), control RYGB group (C + R), diabetic sham surgery group (D), and diabetic RYGB group (D + R). Body weight and blood glucose were monitored before and after surgery every week. Eight weeks after surgery, all rats were sacrificed and the serum fasting GLP-1 concentrations were measured by ELISA. GLP-1R and DPP-4 expression in hypothalamus and ileum were measured by RT-PCR. Results. The body weight and fasting/random blood glucose in the D + R group decreased significantly compared with the D group (P < 0.05). Serum GLP-1 levels in diabetic rats treated with RYGB were higher than the corresponding sham surgery rats. The expression of GLP-1R of hypothalamus in RYGB-treated diabetic rats was significantly higher than those of the sham surgery diabetic rats and both control group rats (P < 0.05). We found a negative correlation between hypothalamus GLP-1R mRNA and blood glucose level. No significant difference was seen in ileum GLP-1R and DPP-4 expression among all groups. Conclusions. RYGB efficiently promoted serum GLP-1 levels and the expression of GLP-1 receptor in the hypothalamus in diabetic rats. These data suggest that the hypothalamus GLP-1R may play an important role in the GLP-1 system for improving glucose homeostasis after reconstruction of the gastrointestinal tract.

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“…As cirurgias gastrointestinais podem promover a melhora do controle glicêmico por meio da restrição alimentar e da perda de peso, assim os procedimentos cirúrgicos que induzem a perda de peso também podem promover a remissão do DM2 consideravelmente entre indivíduos obesos mórbidos (CELIK et al, 2015). A resolução sustentada do DM foi observada em pacientes com histórico de menor duração da doença previamente à Cirurgia Bariátrica, ou seja, quanto mais cedo for realizada a intervenção cirúrgica no obeso portador de DM, maiores as chances de remissão total do DM e manutenção dos níveis glicêmicos (STOLL et al, 2013). Neste estudo os indivíduos obesos foram submetidos à Cirurgia Bariátrica por meio de técnica mista, restritiva e disabsortiva.…”

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“…Os pacientes DM portadores de periodontite no pré-operatório apresentaram redução na severidade do desfecho, fato provavelmente mediado pelo controle dos parâmetros metabólicos e diminuição significativa do peso (CAMBI et al, 2015;CELIK et al, 2015;CHENG et al, 2014;STOLL et al, 2013). Em G2, também foi observada a redução na periodontite no período PO 6m, porém ao final das avaliações (PO 12m) as diferenças com os obesos em G1 foram minimizadas, apresentando a mesma chance de ocorrer a periodontite (Tabela 6).…”

Section: Condições Periodontais E De Higiene Bucalunclassified

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Condições periodontais e de higiene bucal, qualidade de vida e satisfação com a vida em pacientes obesos diabéticos e não diabéticos submetidos à cirurgia bariátrica

Freitas¹

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O efeito em curto prazo do bypass gástrico sobre pacientes obesos diabéticos

Abstract: Obese patients with DM2 undergoing gastric bypass showed improved glycemic control and reduced use of hypoglycemic agents in the short-term.

Cited by 6 publications

References 29 publications

Immunological Evaluation of Patients With Type 2 Diabetes Mellitus Submitted to Metabolic Surgery

Immunological Evaluation of Patients With Type 2 Diabetes Mellitus Submitted to Metabolic Surgery

The Improvement of Hyperglycemia after RYGB Surgery in Diabetic Rats Is Related to Elevated Hypothalamus GLP-1 Receptor Expression

Condições periodontais e de higiene bucal, qualidade de vida e satisfação com a vida em pacientes obesos diabéticos e não diabéticos submetidos à cirurgia bariátrica

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