Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial

Mingrone, Geltrude; Panunzi, Simona; Gaetano, Andrea De; Guidone, Caterina; Iaconelli, Amerigo; Nanni, Giuseppe; Castagneto, Marco; Bornstein, Stefan R.; Rubino, Francesco

doi:10.1016/s0140-6736(15)00075-6

Cited by 1,057 publications

(817 citation statements)

References 28 publications

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“…Roux-en-Y gastric bypass (RYGB) and biliopancreatic diversion with duodenal switch (BPD/DS) provide considerable and durable weight loss and improve obesity-related diseases such as type 2 diabetes [1,2]. BPD/DS is more effective than RYGB to induce weight loss, improve glycemic control and lipid profiles [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Risstad

Kristinsson

Fagerland

et al. 2017

Surgery for Obesity and Related Diseases

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(2017). Bile acid profiles over 5 years following gastric bypass and duodenal switch -Results from a randomized clinical trial. Surgery for obesity and related diseases. https://doi.org/10.1016/j.soard.2017.05.024Citing this paper Please note that where the full-text provided on King's Research Portal is the Author Accepted Manuscript or Post-Print version this may differ from the final Published version. If citing, it is advised that you check and use the publisher's definitive version for pagination, volume/issue, and date of publication details. And where the final published version is provided on the Research Portal, if citing you are again advised to check the publisher's website for any subsequent corrections. General rightsCopyright and moral rights for the publications made accessible in the Research Portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognize and abide by the legal requirements associated with these rights.•Users may download and print one copy of any publication from the Research Portal for the purpose of private study or research.•You may not further distribute the material or use it for any profit-making activity or commercial gain •You may freely distribute the URL identifying the publication in the Research Portal Take down policy If you believe that this document breaches copyright please contact librarypure@kcl.ac.uk providing details, and we will remove access to the work immediately and investigate your claim. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Introductionmentioning

confidence: 99%

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Risstad

Kristinsson

Fagerland

et al. 2017

Surgery for Obesity and Related Diseases

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“…A systematic review and meta-analysis of the long term (3 years) effectiveness of bariatric surgery compared to non-surgical intervention established that bariatric surgery was superior in eliciting: weight loss, remission of diabetes, larger reductions in glycated haemoglobin A1c, and decreased systolic pressure [28]. Furthermore a 5 year controlled trial also confirmed the superiority of surgical intervention over medical management for obesity in T2DM, espousing that over 80% of individuals whom underwent bariatric surgery maintained a glycated haemoglobin A1c of <7% with no or few antidiabetic medications Mingrone et al [29]. Table 4 demonstrates further associated benefits and complications of bariatric surgery and a comparison of lifestyle with pharmaceutical intervention versus bariatric surgery; the evidence confirms that surgical intervention is superior to pharmalogical intervention for obesity in T2DM [30][31][32].…”

Section: Comparison Of Interventionsmentioning

confidence: 96%

Review of the Pharmacological and Bariatric Surgery for Diabesity

Eligar

Gruchy

2017

MOJDDT

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Whilst some drugs are specifically licensed and targeted at weight loss there are also other classes of drugs that can elicit weight loss despite their primary usage or original design being for a different outcome. Table 2 highlights the efficacy of the most common drugs prescribed for weight loss as an adjunct therapy for T2DM.A new treatment being explored is the use of Botulinum Toxin, the premise being that Botox injections into the stomach wall inhibit vagus nerve afferents thus interrupting the brain-gut axis communication pathway resulting in weight loss [17]. Phase two of clinical trial is currently being conducted to assess the efficacy and safety of Botulinum Toxin as a weight loss intervention; this may offer a new innovative treatment for obesity in T2DM. Hypoglycaemia, headaches, diarrhoea [7] 5.8-5.9kg [7] 51-73% [7] Review of the Pharmacological interventions and Bariatric surgery for Diabesity 3/5Copyright: ©2017 Gruchy et al. Citation Surgical Intervention for Obesity in T2DMBariatric surgery is also called gastrointestinal surgery for obesity. Surgery changes the digestive process which elicits weight loss through reduction of nutrient absorption and thus lessens calorie intake [18]. The most common types of bariatric surgery are Adjustable Gastric Banding (AGB), Sleeve Gastrectomy (SG) and Roux-en-Y Gastric Bypass (RYGB). RYGB is currently considered the gold standard of weight loss surgery [18]. The mechanism of weight loss and differences in outcomes of these procedures can be seen in Table 3. Indications for bariatric surgery are people with a BMI of 40 kg/m 2 or greater, or those with a BMI of 35 kg/m 2 or greater with co morbidities, such as T2DM (NICE, 2014). The NICE guidelines [19] advice that people diagnosed with T2DM in the past 10 years should receive expedited referrals without the need of having tried lifestyle management interventions first, due to improvements in quality of life and reduced risk of mortality that bariatric surgery can offer. Explored the effects of bariatric surgery during different stages of T2DM progression [20]. The results demonstrated that bariatric surgery during early onset of T2DM elicited highest rates of T2DM remission and reduced micro and macrovascular complications, whereas bariatric surgery on people with T2DM with existing micro or macrovascular complications produced no improvements in life expectancy or regression of microvascular complications [20]. Bariatric surgery is considered the most sustainable and effective management for obesity (class III) [21]. Several studies purport that weight loss through bariatric surgery is cost-effective compared to nonsurgical management [22,23,11].Following RYGB surgery NEFA levels initially increase with fat deployment through rapid weight loss, levels of NEFA normalise as weight loss plateaus Dirksen et al. [24]. SG and RYGB affect pancreatic β cell function, NEFA levels and insulin sensitivity thus enhancing glucose metabolism Thomas et al. [25].A meta-analysis by Buchwald et al. [26] demonstrated re...

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“…This study compared LSG to gastric bypass (LSAGB) for the treatment of T2DM in Asian patients with BMI <35 kg/m 2 and was the first study to prove that gastric bypass (a duodenum exclusion procedure) had better efficacy on T2DM remission than LSG (non‐duodenum exclusion procedure). Following this landmark study, many RCT focusing on the comparison of metabolic surgery and medical treatment for the treatment of T2DM have been carried out and universally showed that metabolic surgery is more effective than medical treatment in glycemic control 91, 92, 93, 94, 95, 96, 97, 98, 99. Table 2 lists the results of RCT trials on surgical treatment versus medical treatment for T2DM.…”

Section: From Bariatric To Metabolic Surgerymentioning

confidence: 99%

Recent advancements in bariatric/metabolic surgery

Lee

Almalki

2017

Annals of Gastroent Surgery

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Obesity and type 2 diabetes mellitus (T2DM) are currently two pan‐endemic health problems worldwide and are associated with considerable increase in morbidity and mortality. Both diseases are closely related and very difficult to control by current medical treatment, including diet, drug therapy and behavioral modification. Bariatric surgery has proven successful in treating not just obesity but also in significantly decreasing overall obesity‐associated morbidities as well as improving quality of life in severely obese patients (body mass index [BMI] >35 kg/m2). A rapid increase in bariatric surgery started in the 2000s when the laparoscopic surgical technique was introduced into this field. Many new procedures had been developed and changed the face of modern bariatric surgery. Recently, bariatric surgery played as gastrointestinal metabolic surgery has been proposed as a new treatment modality for obesity‐related T2DM for patients with BMI >35 kg/m2. Strong evidence has demonstrated that bariatric/metabolic surgery is an effective and durable treatment for obese T2DM patients. Bariatric/metabolic surgery is now becoming an important surgical division. The present article examines and discusses recent advancements in bariatric/metabolic surgery and covers four major fields: (i) the rapid increase in numbers and better safety; (ii) new procedures with better outcomes; (iii) from bariatric to metabolic surgery; and (iv) understanding the mechanisms and personalized treatment.

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Bariatric–metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial

Cited by 1,057 publications

References 28 publications

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Bile acid profiles over 5 years after gastric bypass and duodenal switch: results from a randomized clinical trial

Review of the Pharmacological and Bariatric Surgery for Diabesity

Recent advancements in bariatric/metabolic surgery

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