Diabetes remission after bariatric surgery

Chumakova-Orin, Maryna; Vanetta, Carolina; Moris, Dimitrios; Guerrón, Alfredo D.

doi:10.4239/wjd.v12.i7.1093

Cited by 35 publications

(23 citation statements)

References 32 publications

(44 reference statements)

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“…Bariatric surgery is known to result in a marked improvement in obesity complications and comorbidity [17], such as remission in diabetes, reduction in risk of heart disease and improvement in dyslipidemia [18][19][20][21]. The present study examines the question of whether one of the procedures has an advantage in improving metabolic biomarkers that indicate obesity-associated comorbidity.…”

Section: Discussionmentioning

confidence: 96%

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

et al. 2022

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One Anastomosis Gastric Bypass (OAGB) and Sleeve Gastrectomy (SG) are the most common bariatric procedures performed worldwide. SG is a restrictive procedure whereas OAGB involves malabsorption as well, supposing a risk of deficiency development post OAGB. The aim of the study was to compare nutritional deficiencies and metabolic markers one year after the procedures, while adhering to the current protocols. Retrospective analysis was performed for data on 60 adults undergoing primary OAGB, compared to 60 undergoing primary SG. Mean pre-surgery BMI for SG was 42.7 kg/m2 and 43.3 kg/m2 for OAGB. A multidisciplinary team followed up with the patients at least 3 times during the first year. Mean weight loss was 39.0 kg for SG and 44.1 kg for OAGB. The OAGB group presented a significantly sharper decline in T.Chol and a trend for sharper LDL decrease; a higher increase in folate and a trend for a greater decrease in albumin and hemoglobin were observed in OAGB. For vitamin B12, D, iron and ferritin, no difference was observed between the treatment groups, although there were some in-group differences. Nutritional recommendations and adopted supplement plans minimize the risk of deficiencies and result in improvement in metabolic biomarkers one year after OAGB, which was comparable to SG.

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Section: Discussionmentioning

confidence: 96%

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

et al. 2022

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“…Models like Diarem, IMS, and ABCD considered insulin use and the long duration of diabetes to be associated with a low probability of DM2 remission. 10 Tacrolimus use was another factor correlated with diminished DM2 remission. At all follow-up intervals, tacrolimus dose was negatively correlated with diabetes remission, (P = 0.016).…”

Section: Discussionmentioning

confidence: 98%

“…This is consistent with many models developed to predict DM2 remission in patients undergoing bariatric surgery. Models like Diarem, IMS, and ABCD considered insulin use and the long duration of diabetes to be associated with a low probability of DM2 remission 10…”

Section: Discussionmentioning

confidence: 99%

Diabetes Remission After Bariatric Surgery in Patients on Glucocorticoids: A Pilot Study

Vahibe¹,

Livia²,

Portela³

et al. 2021

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: Diabetes mellitus type 2 (DM2) remission after bariatric surgery has long been reported in the medical literature. Glucocorticoid use is associated with weight gain and could theoretically affect diabetes remission post bariatric surgery. Objectives: The aim is to identify remission rates of DM2 among patients using glucocorticoids after bariatric surgery and assess long-term postsurgical follow-up. Methods: A retrospective analysis was performed on patients who used glucocorticoids and underwent bariatric surgery at the Mayo Clinic between 2008 and 2020. Data were analyzed for 3-month, 6-month, 1-year, 2-year, and 5-year intervals for factors indicative of diabetes remission. Results: Within our retrospective search, we identified 92 patients who were on any immunosuppressant medication before surgery. Of those, 22 patients had a diagnosis of DM2 while 18 of them were concurrently on glucocorticoids. Diabetes remission occurred in 11 of the 18 DM2 patients (61.11%). There was a statistically significant negative correlation between diabetes remission and combination therapy with glucocorticoids and tacrolimus (P=0.016); patients with a longer duration of DM2 diagnosis (P=0.024), and patients who used insulin three months after the procedure (P=0.001). However, percent total weight loss and the number of preoperative oral DM2 medications were not associated with worse outcomes. Conclusions: Patients who use systemic glucocorticoids are able to achieve diabetes remission after bariatric surgery. Concurrent therapy with tacrolimus is associated with worse remission outcomes.

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“…Bariatric surgery. Bariatric surgery produces substantial and durable weight loss with commensurate increases in serum testosterone SHBG, LH and FSH concentrations [80], and potentially sustained remission of T2D [81]. The effects of bariatric surgery on serum testosterone are substantial.…”

Section: Serum Testosterone and Type 2 Diabetes Riskmentioning

confidence: 99%

Obesity, type 2 diabetes, and testosterone in ageing men

Wittert

Grossmann

2022

Rev Endocr Metab Disord

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In the absence of obesity, adverse lifestyle behaviours, and use of medication such as opioids serum testosterone concentrations decrease by only a minimal amount at least until very advanced age in most men. Obesity is heterogeneous in its phenotype, and it is the accumulation of excess adipose tissue viscerally associated with insulin resistance, dyslipidaemia, inflammation, hypothalamic leptin resistance and gliosis that underpins the functional hypogonadism of obesity. Both central (hypothalamic) and peripheral mechanisms are involved resulting in a low serum total testosterone concentration, while LH and FSH are typically in the normal range. Peripherally a decrease in serum sex hormone binding globulin (SHBG) concentration only partially explains the decrease in testosterone and there is increasing evidence for direct effects in the testis. Men with obesity associated functional hypogonadism and serum testosterone concentrations below 16 nmol/L are at increased risk of incident type 2 diabetes (T2D); high testosterone concentrations are protective. The magnitude of weight loss is linearly associated with an increase in serum testosterone concentration and with the likelihood of preventing T2D or reverting newly diagnosed disease; treatment with testosterone for 2 years increases the probability of a positive outcome from a lifestyle intervention alone by approximately 40%. Whether the additional favourable benefits of testosterone treatment on muscle mass and strength and bone density and quality in the long-term remains to be determined.

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Diabetes remission after bariatric surgery

Cited by 35 publications

References 32 publications

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

Nutritional Outcomes One Year after One Anastomosis Gastric Bypass Compared to Sleeve Gastrectomy

Diabetes Remission After Bariatric Surgery in Patients on Glucocorticoids: A Pilot Study

Obesity, type 2 diabetes, and testosterone in ageing men

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