Predictive Factors of Type 2 Diabetes Remission 1 Year After Bariatric Surgery: Impact of Surgical Techniques

Robert, M.; Ferrand-Gaillard, C.; Disse, Emmanuel; Espalieu, P.; Simon, Chantal; Laville, Martine; Gouillat, C.; Thivolet, Charles

doi:10.1007/s11695-013-0868-4

Cited by 94 publications

(68 citation statements)

References 21 publications

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“…In fact, surgery leads to a decrease in treatment dose and to suspension in many cases. Findings by a number of researchers support our result that different bariatric procedures have a similar effect in type 2 diabetes mellitus remission [9,11,[25][26][27][28][29]. Contrastingly, other studies show improved type 2 diabetes mellitus remission in patients who underwent gastric bypass compared to patients who underwent other surgical techniques [30,31].…”

Section: Discussionsupporting

confidence: 86%

“…They suggest that acute restriction in calories rather than gut hypertrophy is a key factor in diabetes remission, at least in the early postoperative phase before significant weight loss has resulted. In turn, a recent study of type 2 diabetes mellitus evolution one year after surgery [11] concluded that some baseline parameters could work as predictors of the development of the disease. In our case, some of the baseline predictors of the patient outcome coincide with their results, specifically BMI and glycated haemoglobin.…”

Section: Discussionmentioning

confidence: 99%

“…In this work, we seek to find out the short-and midterm effectiveness of one restrictive technique (LSG) in type 2 diabetes mellitus improvement, weight loss, and related co-morbidities progress, in comparison with two mixed procedures (RYGB and BPD), after one year of follow-up [11]. Furthermore, we try to identify reliable clinical baseline predictors of the likelihood of type 2 diabetes mellitus remission after these different surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

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Remisja cukrzycy typu 2 po leczeniu bariatrycznym — porównanie różnych procedur

Fernández-Soto¹,

Martín-Leyva²,

González-Jiménez³

et al. 2017

Endokrynologia Polska

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Introduction: We aimed to assess the mid-term type 2 diabetes mellitus recovery patterns in morbidly obese patients by comparing some relevant physiological parameters of patients of bariatric surgery between two types of surgical procedures: mixed (roux-en-Y gastric bypass and biliopancreatic diversion) and restrictive (sleeve gastrectomy). Material and methods: This is a prospective and observational study of co-morbid, type 2 diabetes mellitus evolution in 49 morbidly obese patients: 37 underwent mixed surgery procedures and 12 a restrictive surgery procedure. We recorded weight, height, body mass index, and glycaemic, lipid, and nutritional blood parameters, prior to procedure, as well as six and twelve months post-operatively. In addition, we tested for differences in patient recovery and investigated predictive factors in diabetes remission. Results: Both glycaemic and lipid profiles diminished significantly to healthy levels by 6 and 12 months post intervention. Type 2 diabetes mellitus showed remission in more than 80% of patients of both types of surgical procedures, with no difference between them. Baseline body mass index, glycated haemoglobin, and insulin intake, among others, were shown to be valuable predictors of diabetes remission one year after the intervention. Conclusions:The choice of the type of surgical procedure did not significantly affect the remission rate of type 2 diabetes mellitus in morbidly obese patients. (Endokrynol Pol 2017; 68 (1): 18-25)

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Remisja cukrzycy typu 2 po leczeniu bariatrycznym — porównanie różnych procedur

Fernández-Soto¹,

Martín-Leyva²,

González-Jiménez³

et al. 2017

Endokrynologia Polska

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“…While these procedures restructure the gut in various ways, all of them result in comorbid disease remission including T2DM[1203639108118154162166168171173189193202212213214221224231249265273] and MetS,[7303245121132174177183199225243250260270274275] even if at a variable rate and durability;[12314878828397108114168208221224243244267275] though remission has been reported in a number of publications to be durable[139168178191] and immediate prior to significant weight loss. [2074161187188190195]…”

Section: Bariatric Surgery Impact On Hepatic O2mentioning

confidence: 99%

Metabolic syndrome and the hepatorenal reflex

Wider¹

2016

Surg Neurol Int

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Insufficient hepatic O2 in animal and human studies has been shown to elicit a hepatorenal reflex in response to increased hepatic adenosine, resulting in the stimulation of renal as well as muscle sympathetic nerve activity and activating the renin angiotensin system. Low hepatic ATP, hyperuricemia, and hepatic lipid accumulation reported in metabolic syndrome (MetS) patients may reflect insufficient hepatic O2 delivery, potentially accounting for the sympathetic overdrive associated with MetS. This theoretical concept is supported by experimental results in animals fed a high fructose diet to induce MetS. Hepatic fructose metabolism rapidly consumes ATP resulting in increased adenosine production and hyperuricemia as well as elevated renin release and sympathetic activity. This review makes the case for the hepatorenal reflex causing sympathetic overdrive and metabolic syndrome in response to exaggerated splanchnic oxygen consumption from excessive eating. This is strongly reinforced by the fact that MetS is cured in a matter of days in a significant percentage of patients by diet, bariatric surgery, or endoluminal sleeve, all of which would decrease splanchnic oxygen demand by limiting nutrient contact with the mucosa and reducing the nutrient load due to loss of appetite or dietary restriction.

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“…Thus, higher baseline C-peptide, lower blood glucose, absence of insulin therapy, and better-preserved ␤-cell function before surgery have all been associated with more successful T2DM resolution after one or another bariatric procedures (13)(14)(15). Consistent with this, patients with longer duration of diabetes and worse ␤-cell function had smaller declines in HbA1c than those with a shorter time from diagnosis, despite comparable weight loss (16).…”

mentioning

confidence: 71%