Impact of gastrointestinal bypass on nonmorbidly obese type 2 diabetes mellitus patients after gastrectomy

Pak, Jun; Kwon, Yeongkeun; Menzo, Emanuele Lo; Szomstein, Samuel; Rosenthal, Raúl J.

doi:10.1016/j.soard.2014.12.008

Cited by 11 publications

(7 citation statements)

References 27 publications

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“…In particular, the preoperative A1C level was found to have a significant influence on diabetes improvement during the short- and long-term follow-up. This result is consistent with findings from previous studies [ 24 28 29 ]. Several reports showed that low A1C levels have a positive effect on diabetes improvement after bariatric surgery [ 24 29 ].…”

Section: Discussionsupporting

confidence: 94%

“…This result is consistent with findings from previous studies [ 24 28 29 ]. Several reports showed that low A1C levels have a positive effect on diabetes improvement after bariatric surgery [ 24 29 ]. Moreover, preoperative A1C levels may be related to the severity of T2D in preoperative patients, suggesting that serious progression of diabetes tends to lower the effectiveness of bariatric surgery.…”

Section: Discussionsupporting

confidence: 94%

“…Bariatric surgery is designed for weight loss in the morbidly obese population and is also known to have a metabolic effect that can improve diabetes [ 23 24 ]. In addition, one meta-analysis found improvement in 86.6% of T2D patients who received bariatric surgery [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

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Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery

Lee

Jung

et al. 2017

J Gastric Cancer

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PurposeThis study primarily aimed to investigate the short- and long-term remission rates of type 2 diabetes (T2D) in patients who underwent surgical treatment for gastric cancer, especially patients who were non-obese, and secondarily to determine the potential factors associated with remission.Materials and MethodsWe retrospectively reviewed the clinical records of patients with T2D who underwent radical gastrectomy for gastric cancer, from January 2008 to December 2012.ResultsT2D improved in 39 out of 70 (55.7%) patients at the postoperative 2-year follow-up and 21 of 42 (50.0%) at the 5-year follow-up. In the 2-year data analysis, preoperative body mass index (BMI) (P=0.043), glycated hemoglobin (A1C) level (P=0.039), number of anti-diabetic medications at baseline (P=0.040), reconstruction method (statistical difference was noted between Roux-en-Y reconstruction and Billroth I; P=0.035) were significantly related to the improvement in glycemic control. Unlike the results at 2 years, the 5-year data analysis revealed that only preoperative BMI (P=0.043) and A1C level (P=0.039) were statistically significant for the improvement in glycemic control; however, the reconstruction method was not.ConclusionsAll types of gastric cancer surgery can be effective in short- and long-term T2D control in non-obese patients. In addition, unless long-limb bypass is considered in gastric cancer surgery, the long-term glycemic control is not expected to be different between the reconstruction methods.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionsupporting

confidence: 94%

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Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery

Lee

Jung

et al. 2017

J Gastric Cancer

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“…According to several studies, the most signi cant independent predictors were the duration and severity of T2DM [8, 14, 15, 20-22, 25, 28, 34, 36, 40, 41] (preoperative diabetes duration, insulinogenic index, and HbA1c level) and weight loss [8,17,20,22,34,36,40] (preoperative BMI, and BMI reduction rate).…”

Section: Summary Of Evidencementioning

confidence: 99%

Oncometabolic Surgery: The Metabolic Effects and Effectiveness of the Different Reconstruction Methods used in Gastric Cancer Surgery. A Systematic Review and Meta-Analysis

Costa,

Santos-Sousa,

Oliveira

et al. 2024

Preprint

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Background Gastric Cancer (GC) is the fifth most common cancer worldwide. Early stages of GC began being detected, giving rise to a new concern, Quality of Life. This study aimed to systematically assess the effects of different GC reconstruction techniques on postoperative type 2 diabetes mellitus (T2DM), hypertension (HBP), and body mass index (BMI) reduction rate and to provide an overview of recent research on oncometabolic surgery (OS). Methods We performed a systematic review and meta-analysis by searching three databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We performed a meta-analysis of risk ratios and mean differences to estimate the impact of duodenal bypass, Roux-en-Y reconstruction, and residual stomach on T2DM, HBP, and BMI reduction rate. Heterogeneity was assessed using the I2 statistics. Results At the end of the follow-up, the duodenal bypass group compared to Billroth I had a significantly higher postoperative remission of T2DM and HBP, with a relative risk (RR) of 1.43 (95%confidence interval (95%CI)[1.27; 1.62]) and 1.3 (95%CI[1.00; 1.69]), respectively. Compared with the Billroth II group, Roux-en-Y reconstruction had significantly greater T2DM remission after gastrectomy (RR = 1.19; 95%CI[1.08; 1.31]), while HBP showed no significant differences. Regarding the improvement of HBP, total gastrectomy was significantly superior to subtotal gastrectomy (95%CI[1.01; 2.64]). A trend towards Roux-en-Y Esophagojejunostomy as the best option for T2DM remission was observed (95%CI[0.98; 2.77]; p = 0.06). Discussion Gastrectomy with Roux-en-Y reconstruction appears to be the most effective treatment for T2DM remission. Further research is needed to assess the impact of OS on metabolic diseases.

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“…Subsequently, RY gastric bypass and sleeve gastrectomy (SG) were performed in T2DM patients, resulting in acceptable remission and improvement rates. There are summaries of the published studies of metabolic surgery in Tables 1 , 2 [ 11 12 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 ]. Although there are limitations to these, such as short durations of follow-up, the small size of the studies, varying definitions of remission, and various types of surgery, these all resulted in improvements in glycemic control and suggested mechanisms for these effects.…”

Section: Bariatric and Metabolic Surgery For Patients With T2dm In Komentioning

confidence: 99%

Metabolic Surgery in Korea: What to Consider before Surgery

Kim

Heo

2017

Endocrinol Metab

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Obesity is increasing globally and represents a significant global health problem because it predisposes towards various diseases, such as type 2 diabetes mellitus, cardiovascular disease, degenerative joint disease, and certain types of cancer. Numerous studies have shown that bariatric surgery reduces body mass and ameliorates obesity-related complications, such as hypertension and hyperglycemia, suggesting that surgery is the most effective therapeutic option for severely obese and obese diabetic patients. Recent international guidelines recommend surgical treatment for diabetic patients with class III obesity (body mass index [BMI] >40 kg/m2), regardless of their level of glycemic control or the complexity of their glucose-lowering regimens, and for patients with class II obesity (BMI 35.0 to 39.9 kg/m2) and hyperglycemia that is poorly controlled despite appropriate lifestyle and pharmacological therapy. The most popular procedures are Roux-en-Y gastric bypass and sleeve gastrectomy, but new procedures with better outcomes have been reported. For optimal surgical outcome, comprehensive management including assessments of a medical condition, nutrition, mental health, and social support is needed before and after surgery. However, there is still a lack of understanding regarding metabolic surgery in Korea. Therefore, this article reviews indications for metabolic surgery in patients with a specific focus on the situation in Korea.

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Impact of gastrointestinal bypass on nonmorbidly obese type 2 diabetes mellitus patients after gastrectomy

Cited by 11 publications

References 27 publications

Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery

Long-term Follow-up for Type 2 Diabetes Mellitus after Gastrectomy in Non-morbidly Obese Patients with Gastric Cancer: the Legitimacy of Onco-metabolic Surgery

Oncometabolic Surgery: The Metabolic Effects and Effectiveness of the Different Reconstruction Methods used in Gastric Cancer Surgery. A Systematic Review and Meta-Analysis

Metabolic Surgery in Korea: What to Consider before Surgery

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