Metabolic Surgery for Dabetes Mellitus between Benefits and Risks

Fica, Simona

doi:10.4183/aeb.2015.212

Cited by 4 publications

(4 citation statements)

References 62 publications

(58 reference statements)

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“…As the metabolic syndrome correlation with CVD risk and overall mortality was demonstrated for both lean and obese subjects (7,8), the accurate evaluation of the metabolic syndrome parameters is a more valuable follow-up parameter for bariatric patients than BMI and weight loss (9).…”

Section: Introductionmentioning

confidence: 99%

Middle Term Impact of Sleeve Gastrectomy on Major Cardiovascular Risk Factors in a Group of Romanian Obese Patients

et al. 2017

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Background and aim. The goals of bariatric surgery are to improve the quality of life by lowering body mass index (BMI) but also to treat obesity comorbidities. The aim of our study was to evaluate the impact of laparoscopic sleeve gastrectomy (LSG) on metabolic parameters. Methods. 85 obese patients treated by bariatric surgery LSG procedure were included in the study. Basal, 6 and 12 months after surgery serum glucose levels and lipid fractions were measured. Metabolic syndrome criteria according to IDF 2006 were evaluated at baseline and after bariatric surgery. Results. Our group included 61.2 % female patients, the mean age was 40.2 ±10.2 years and the metabolic syndrome criteria at baseline were confirmed in 69.4% of the study group. At twelve months after the intervention, the mean excess weight loss (%EWL) was 72%, with age and BMI subgroups variations. We found significant improvements of serum concentrations for triglycerides (P-value = 0.001, decreased by 30%), HDL-cholesterol (P-value = 0.017, increased by 26%), total cholesterol (P-value = 0.043, decreased by 12%) and glucose (P-value = 0.007, decreased by 12%). Conclusions. The positive effect of bariatric surgery was confirmed for lipid fractions and fasting glucose levels, also the metabolic syndrome prevalence was significantly reduced, all these changes contribute to lower cardiovascular risk together with significant weight loss.

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Section: Introductionmentioning

confidence: 99%

Middle Term Impact of Sleeve Gastrectomy on Major Cardiovascular Risk Factors in a Group of Romanian Obese Patients

et al. 2017

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“…Moreover, in this study men who were qualified for RYGB had significantly higher levels of GGTP than men qualified for SG, which can be a factor predisposing for cholestasis. As reported by Fica and Sirbu [26], RYGB is related to a 40% risk of cholelithiasis. Cholestasis may be caused by both preoperative conditions of patients -obesity and nutritional errors (small number of meals and insufficient intake of dietary fibre -which adversely affect the process of gall bladder contraction and lead to deficiencies in unsaturated fatty acids, which in turn results in decreased amount of lecithin in bile) and quick body weight loss after the operation.…”

Section: Discussionmentioning

confidence: 56%

Profiles of patients qualified for bariatric surgeries with Roux-en-Y gastric bypass and sleeve gastrectomy methods

Komorniak¹,

Hoffmann²,

Kowalewski³

et al. 2020

jhi

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Introduction: Bariatric surgery is one of the methods of extreme obesity treatment used in case of patients with body mass index (BMI) ≥ 40 kg/m 2 or BMI ≥ 35 kg/m 2 and accompanying diseases (e.g. hypertension) for whom previous conservative treatment was not successful. Aim of the study: To determine the anthropometric and biochemical profiles of patients qualified for Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG). Material and methods: The study involved 60 patients qualified for surgical treatment. The standardized Food Frequency Questionnaire supplemented by a survey which contained questions on previous attempts to lose weight and their results (including yo-yo effect) were administered. The anthropometric measurements included weight, height, waist and hip circumference. Biochemical analysis of blood (lipid profile, liver profile, glucose, glycated haemoglobin and C-reactive protein) were performed using calorimetric method. All the results were statistically analysed using the STATISTICA 12 software. Results: The patients had a history of numerous attempts (≥ 6) to lose weight using unbalanced diets. Women qualified for SG had higher levels of parameters indicating the presence of inflammatory state, dyslipidaemia and improper glycaemia. Men qualified for RYGB had significantly higher values of γ-glutamyl transpeptidase. Conclusions: Numerous unsuccessful attempts to lose weight can signify a low level of nutritional knowledge and the need to educate the patients both before and after the surgery. Patients at higher perioperative risk (due to anthropometric and biochemical parameters) were qualified to less invasive surgery treatment. Higher risk of developing cholelithiasis after the surgery would be attributed to irrational attempts of body weight loss before the procedure, and not to the RYGB itself.

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“…While this issue dates back from The University Group Diabetes Program, where tolbutamide was associated with a significant increase in all-cause and cardiovascular mortality, the more robustly conducted UK Prospective Diabetes Study showed no increased mortality in relation to sulphonylurea exposure (13,14). Many other treatment options for type 2 diabetes are now available, and all have their up-and downsides (15,16).…”

Section: Discussionmentioning

confidence: 99%

Patients Treated with Insulin and Sulphonylurea are at Increased Mortality Risk as Compared with Insulin Plus Metformin

et al. 2017

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Aims. To investigate the effect of sulphonylurea (SU) treatment on all-cause and cardiovascular mortality as compared with metformin (MET), when used in combination with insulin (INS) in type 2 diabetes. Methods. All type 2 diabetes patients aged ≥40 years were included at their first prescription of INS+MET or INS+SU, during 2001-2008. They were considered at risk until death or December 31 st , 2011. Mortality rates were calculated per 1000 person-years. Crude and adjusted rate ratios (RR) were calculated using time dependent analysis with INS+MET as reference. Results. There were 7122 patients (60.8% women) included in the analysis, with a mean age at baseline of 62.0±9.9 years. During the 11 years of study, patients on INS+MET contributed 13620 person-years and 330 deaths (mortality rate 24, CI95% 22-27), while those on INS+SU contributed 8720 person-years and 393 deaths (mortality rate 45, CI95% 41-50). Adjusted all-cause mortality RR were: SU 1.6 (CI95% 1.21-2.11, p<0.001), glimepiride 1.18 (CI95% 0.73-1.91, p=0.51), gliclazide 1.78 (CI95% 1.07-2.95, p=0.024), glibenclamide 1.66 (CI95% 0.71-3.88, p=0.23), glipizide 1.24 (CI95% 0.68-2.27, p=0.49), and gliquidonum 2.32 (CI95% 1.54-3.50, p=0.001). Conclusions. When combined with insulin as dual therapy, patients treated with SU were at increased mortality risk as compared with insulin + MET.

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Metabolic Surgery for Dabetes Mellitus between Benefits and Risks

Cited by 4 publications

References 62 publications

Middle Term Impact of Sleeve Gastrectomy on Major Cardiovascular Risk Factors in a Group of Romanian Obese Patients

Middle Term Impact of Sleeve Gastrectomy on Major Cardiovascular Risk Factors in a Group of Romanian Obese Patients

Profiles of patients qualified for bariatric surgeries with Roux-en-Y gastric bypass and sleeve gastrectomy methods

Patients Treated with Insulin and Sulphonylurea are at Increased Mortality Risk as Compared with Insulin Plus Metformin

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