Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery

Sjöström, Lars; Lindroos, Anna‐Karin; Peltonen, Markku; Torgerson, Jarl; Bouchard, Claude; Carlsson, Björn; Dahlgren, S; Larsson, Bo; Narbro, Kristina; Sjöström, C. David; Sullivan, Marianne; Wedel, Hans

doi:10.1056/nejmoa035622

Cited by 4,012 publications

(2,546 citation statements)

References 36 publications

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“…128 The durability of the effect of bariatric surgery on glycaemic control has been observed in the Swedish Obese Subjects Study; 72% of individuals with T2D achieved remission two years after surgery and 36% had maintained T2D remission 10 years after surgery. 129 Meta-analysis data report that 62% of patients with T2D remained free of diabetes for more than two years following surgery. 130 Identifying the characteristics of patients likely to obtain the greatest benefit from surgery is critical.…”

Section: Bariatric Surgerymentioning

confidence: 99%

Targeting beta-cell preservation in the management of type 2 diabetes

2017

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Type 2 diabetes (T2D) is widely considered a chronic and progressive disease without cure. As beta-cell function progressively declines over time, blood glucose rises. Current management of T2D involves incremental introduction of dietary and drug therapies to achieve normoglycaemia. However, recent studies have demonstrated remission of T2D following bariatric surgery, very low calorie diet or intensive insulin therapy, raising the possibility that the declining beta-cell function in T2D may be arrested or even reversed. The point at which such interventions are introduced in the course of T2D is key for clinical benefit. Future treatment strategies should be revised to target early betacell preservation and thus disease remission. This article reviews the pathogenesis of beta-cell dysfunction and evidence for the clinical benefit of preserving beta-cell function in T2D, and discusses the evidence for beta-cell preservation of current glucose-lowering therapies with particular reference to their effect when initiated at the time of diagnosis of T2D. Br J Diabetes 2017;17:134-144

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Section: Bariatric Surgerymentioning

confidence: 99%

Targeting beta-cell preservation in the management of type 2 diabetes

2017

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“…As a consequence, this has important economic implications for health care systems worldwide [10]. The results of surgical treatment of morbid obesity are by far more promising than those of conservative therapeutic approaches [11]. Bariatric surgery reduces not only morbidity but also mortality, as has been recently shown [7,8].…”

Section: Discussionmentioning

confidence: 99%

Sudden death after open gastric bypass surgery

Wölnerhanssen

Langer

Eriksson

et al. 2008

Langenbecks Arch Surg

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“…Bariatric surgery is the most effective method for the treatment of severe obesity 112, 121, 122. Referral is considered for patients with a BMI ≥35 kg m −2 and associated comorbidities, or a BMI of 40 kg m −2 , after failure of lifestyle modification and pharmacotherapies 124.…”

Section: Surgerymentioning

confidence: 99%

Weight maintenance: challenges, tools and strategies for primary care physicians

2015

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SummaryObesity is recognized as a chronic disease and one of the major healthcare challenges facing us today. Weight loss can be achieved via lifestyle, pharmacological and surgical interventions, but weight maintenance remains a lifetime challenge for individuals with obesity. Guidelines for the management of obesity have highlighted the role of primary care providers (PCPs). This review examines the long‐term outcomes of clinical trials to identify effective weight maintenance strategies that can be utilized by PCPs. Because of the broad nature of the topic, a structured PubMed search was conducted to identify relevant research articles, peer‐reviewed reviews, guidelines and articles published by regulatory bodies. Trials have demonstrated the benefit of sustained weight loss in managing obesity and its comorbidities. Maintaining 5–10% weight loss for ≥1 year is known to ameliorate many comorbidities. Weight maintenance with lifestyle modification – although challenging – is possible but requires long‐term support to reinforce diet, physical activity and behavioural changes. The addition of pharmacotherapy to lifestyle interventions promotes greater and more sustained weight loss. Clinical evidence and recently approved pharmacotherapy has given PCPs improved strategies to support their patients with maintenance of weight loss. Further studies are needed to assess the translation of these strategies into clinical practice.

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Lifestyle, Diabetes, and Cardiovascular Risk Factors 10 Years after Bariatric Surgery

Abstract: As compared with conventional therapy, bariatric surgery appears to be a viable option for the treatment of severe obesity, resulting in long-term weight loss, improved lifestyle, and, except for hypercholesterolemia, amelioration in risk factors that were elevated at baseline.

Cited by 4,012 publications

References 36 publications

Targeting beta-cell preservation in the management of type 2 diabetes

Targeting beta-cell preservation in the management of type 2 diabetes

Sudden death after open gastric bypass surgery

Weight maintenance: challenges, tools and strategies for primary care physicians

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