Surgical Treatment of Type 2 Diabetes in Subjects with Mild Obesity: Mechanisms Underlying Metabolic Improvements

Abstract

RYGBP improves the glucose metabolism in subjects with type 2 diabetes and mild obesity. This effect is associated with improvement of insulin sensitivity, beta-cell secretory function, and incretin secretion.

Serum Leptin and Adiponectin Concentration in Type 2 Diabetes Patients in the Short and Long Term Following Biliopancreatic Diversion

“…In the subjects of this study, the lack of a negative correlation between BMI by the one hand and serum adiponectin and BMI values by the other observed before surgery supports the hypothesis that, in T2DM, the dysregulation in the cytokine system actually contributes to metabolic derangement [24,41].…”

“…This suggests that, as in the uncomplicated obese subjects, in the T2DM patients undergoing bariatric surgery, the serum leptin level proportionally follows the body weight [23,[39][40][41][42]: the serum leptin level results sharply reduced at 1 year after the operation and, at a longer term, being the body weight substantially stable, remain nearly unchanged. Furthermore the serum leptin concentration seems to be completely independent of the metabolic conditions: in fact, the values were strictly associated with body weight at any follow-up point, and in both the patients having reached a positive metabolic outcome and their counterparts with a negative postoperative outcome, substantially similar data were obtained.…”

“…Recent studies [40][41][42] have shown that the increased insulin secretion/production, as evidenced by the AIR values or the disposition index data, plays an essential role in the short- Association (with trend) between the serum adiponectin concentration and acute insulin response (AIR) to intravenous glucose preoperatively (a, rho = 1.94, p = ns) and at the first postoperative year (b, rho = 0.467, p < 0.012) and at the fifth postoperative year (c, rho = 0.297, p < 0.04) and long-term remissions of T2DM after BPD. The progressive increase of adiponectin levels in the postoperative T2DM remitter patients and the positive association between insulin action and serum adiponectin concentration after operation suggest a role for the recovery of cytokine balance in the T2DM remission.…”

Effect of Bariatric Surgery on the Circulating Level of Adiponectin, Chemerin, Plasminogen Activator Inhibitor-1, Leptin, Resistin, and Visfatin: A Systematic Review and Meta-Analysis

“…In addition, studies were performed in subjects with different baseline BMIs, 7 were in subjects between 30-39.9 kg/m 2 [29,40,72,75,94,99,111]…”

Diabetes Remission Rate in Different Bmi Grades Following Roux-en-Y Gastric Bypass

“…Despite the evidence of the effectiveness of bariatric surgery in the treatment of T2DM, its role as a primary therapeutic option for its control in grade 1 obese patients has not yet been defined. The literature regarding this patient population is based on a small number of case series, but results have been encouraging 1 , 8 , 11 , 12 , 15 - 17 , 20 , 22 , 26 , 31 .…”