Surgical Versus Medical Treatment of Type 2 Diabetes Mellitus in Nonseverely Obese Patients

Müller‐Stich, Beat P.; Senft, Jonas D; Warschkow, René; Kenngott, Hannes; Billeter, Adrian T.; Vit, Gianmatteo; Helfert, Stefanie; Diener, Markus K.; Fischer, Lars; Büchler, Markus W.; Nawroth, Peter P.

doi:10.1097/sla.0000000000001014

Cited by 129 publications

(78 citation statements)

References 58 publications

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“…However, the most recent review identified two RCTs and six observational studies that were conducted in patients with a BMI < 35 kg/m 2 , with five of these reporting on T2DM remission. 76 Meta-analyses of the five studies, combined with an additional three publications that included patients with mild obesity non-exclusively, gave a pooled OR of 14.1 (95% CI 6.7 to 29.9).…”

Section: Type 2 Diabetes Remissionmentioning

confidence: 99%

“…73 Three reviews focused on the potential of bariatric surgery to treat T2DM in patients who were not morbidly obese (BMI < 40 kg/m 2 ). [74][75][76] The two older reviews identified one RCT of 60 patients with a BMI of 30-40 kg/m 2 who underwent adjustable gastric banding that reported on remission. 165 After 2 years, 73% of the surgery group and 13% of the controls were in remission from T2DM (p < 0.001).…”

Section: Type 2 Diabetes Remissionmentioning

confidence: 99%

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Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Gulliford

Charlton

Booth

et al. 2016

Health Serv Deliv Res

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et al. Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records. Health Serv Deliv Res 2016;4(17). Health Services and Delivery ResearchISSN 2050-4349 (Print) ISSN 2050-4357 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full HS&DR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/hsdr. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Health Services and Delivery Research journalReports are published in Health Services and Delivery Research (HS&DR) if (1) they have resulted from work for the HS&DR programme or programmes which preceded the HS&DR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. HS&DR programmeThe Health Services and Delivery Research (HS&DR) programme, part of the National Institute for Health Research (NIHR), was established to fund a broad range of research. It combines the strengths and contributions of two previous NIHR research programmes: the Health Services Research (HSR) programme and the Service Delivery and Organisation (SDO) programme, which were merged in January 2012.The HS&DR programme aims to produce rigorous and relevant evidence on the quality, access and organisation of health services including costs and outcomes, as well as research on implementation. The programme will enhance the strategic focus on research that matters to the NHS and is keen to support ambitious evaluative research to improve health services.For more information about the HS&DR programme please visit the website: http://www.nets.nihr.ac.uk/programmes/hsdr This reportThe research reported in this issue of the journal was funded by the HS&DR programme or one of its preceding programmes as project number 12/5005/12. The contractual start date was in October 2013. The final report began editorial review in October 2015 and was accepted for publication in February 2016. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The HS&DR editors and production house have tried to ensure the accuracy of the authors' report and would like to thank the reviewers for their constructive comments on the final report document. However, they do not accept liability for damages or losses arising from material published in this report.This report presents independent research funded by the National Institute for Health Research (NIHR). The views and opinions expressed by authors in this publication are those of the authors and do not necessarily reflect those of the NHS, the NIHR, NETSCC, the HS&DR programme or the Department of Health. If there are verbatim quotations included in this publication the views and opinion...

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Section: Type 2 Diabetes Remissionmentioning

confidence: 99%

Section: Type 2 Diabetes Remissionmentioning

confidence: 99%

Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Gulliford

Charlton

Booth

et al. 2016

Health Serv Deliv Res

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“…It has been demonstrated that metabolic surgery is able to effectively regulate T2DM and obesity (31). Although innovative procedures to treat diabetes are being investigated, including the novel anti-diabetic drugs, DDP-4 inhibitor and SGLT-2 inhibitor, as well as surgical treatment by laparoscopic sleeve gastrectomy, RYGBP and IT, their precise mechanisms of action remain to be elucidated (32,33). In the present study, the effects of three surgical treatments on a rat model of T2DM were investigated.…”

Section: Discussionmentioning

confidence: 99%

Effect of gastric bypass combined with ileal transportation on type 2 diabetes mellitus

et al. 2018

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Abstract. Type 2 diabetes mellitus (T2DM) is a chronic progressive disease, which manifests as an endocrine disorder. Among the different methods of surgery available to treat patients with T2DM, Roux-en-Y gastric bypass (RYGBP) and ileal transposition (IT) are the most commonly performed. The aim of the present study was to investigate the effects of RYGBP combined with IT on rats with T2DM. A total of 8 healthy male rats were used as a control group and 40 GK rats were randomly divided into 5 groups: A diabetes mellitus (DM) group, a sham operative group (SO), a RYGBP group, an IT group and a RYGBP+IT group. The results demonstrated that fasting blood glucose, triglyceride, total cholesterol and gastric inhibitory polypeptide levels in all treatment groups were significantly lower than those of the SO and DM groups. Furthermore, levels TC and TG in the RYGBP+IT group were significantly lower than in the RYGBP and IT groups. Levels of phosphoenolpyruvate carboxykinase and glucose-6-phosphatase mRNA and IRS-2 protein in all treatment groups were also significantly lower than those of the SO group; and they were significantly lower in the RYGBP+IT group compared with the RYGBP and IT groups. The expression of phosphorylated Akt in the treatment groups was significantly higher than the SO group and was significantly higher in the RYGBP+IT group compared with the RYGBP and IT groups. These results indicate that RYGBP and IT surgical treatment can induce T2DM remission by mediating the expression of insulin-related factors to reverse insulin resistance. The current study also indicated that the effect of RYGBP combined with IT may be developed as a novel first-line method of treating T2DM.

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“…With regard to type 2 DM, the most important and common outcomes evaluated in clinical trials assessing for therapy effectiveness are glycemia, glycated hemoglobin (HbA1C) levels, insulin sensitivity/resistance and elimination of antidiabetic drugs (also known as "diabetes remission"). However, current therapies, other than bariatric surgery, have failed to demonstrate significant effects on the ultimate goal of type 2 DM therapy, disease remission [14,15]. Hence, this metabolic pathology is commonly referred, thus far, as an incurable and progressive disease.…”

Section: Clinical Outcomes With Vlcds In Type 2 Dmmentioning

confidence: 99%

Very Low-Calorie Diets in Type 2 Diabetes Mellitus: Effects on Inflammation, Clinical and Metabolic Parameters

Román-Pintos¹,

Villegas-Rivera²,

Cardona-Muñóz³

et al. 2018

Diabetes and Its Complications

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Type 2 diabetes mellitus (DM) is a chronic and multifactorial disease strongly linked to a low-grade inflammatory process. Thus far, type 2 DM is generally regarded as an incurable disease by common therapies. However, very low-calorie diet (VLCD) regimens have demonstrated beneficial and rapid effects on glucose metabolism in subjects with type 2 DM. These beneficial effects include improvement of diabetes complications, insulin sensitivity and reduction in glycaemia, glycated hemoglobin (HbA1C), and triglyceride levels. VLCD regimens commonly comprise no more than 800 kcal/day and are therefore associated with rapid weight loss in overweight and obese individuals. This group of diets positively affects local/systemic inflammation and oxidative stress (OS) by modulating inflammatory cytokines, adipokines and endogenous antioxidant levels. The investigation of VLCDs in the field of type 2 DM treatment is progressively augmenting due to the multiple benefits in cardiometabolic health of overweight/obese subjects with type 2 DM. Here, we gather and review the evidence regarding the role of inflammation and OS in individuals with type 2 DM under VLCD regimens.

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Surgical Versus Medical Treatment of Type 2 Diabetes Mellitus in Nonseverely Obese Patients

Abstract: Metabolic surgery is superior to medical treatment for short-term remission of T2DM and comorbidities. Further RCTs should address the long-term effects on T2DM complications and mortality.

Cited by 129 publications

References 58 publications

Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Costs and outcomes of increasing access to bariatric surgery for obesity: cohort study and cost-effectiveness analysis using electronic health records

Effect of gastric bypass combined with ileal transportation on type 2 diabetes mellitus

Very Low-Calorie Diets in Type 2 Diabetes Mellitus: Effects on Inflammation, Clinical and Metabolic Parameters

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