The role of diabetes severity scores in predicting disease remission in patients with BMI &gt; 50 kg/m2 undergoing Roux-En-Y gastric bypass and sleeve gastrectomy: a multi-centered study

Ghusn, Wissam; Ma, Pearl; Ikemiya, Kayla; Hage, Karl; Abboud, Donna Maria; Vierkant, Robert A.; Kendrick, Michael L.; Higa, Kelvin; Acosta, Andrés; Ghanem, Omar M.

doi:10.1007/s00464-023-10186-8

Cited by 8 publications

(2 citation statements)

References 20 publications

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“…In our study, multivariate logistic regression analysis also found no significant difference between LSG and LRYGB in terms of DR, which aligns with the results of other studies. 28,29 The present study indicates that high levels of HbA1c, longer duration of diabetes and preoperative insulin-requiring are independent risk factors for DR, consistent with previous studies. [30][31][32][33] Clinical markers of advanced diabetes, such as shorter duration of diabetes, better glycaemic control, fewer medications and no insulin use, suggest the presence of greater functional β-cell reserve.…”

Section: Discussionsupporting

confidence: 92%

Construction and validation of a nomogram for predicting diabetes remission at 3 months after bariatric surgery in patients with obesity combined with type 2 diabetes mellitus

Yuan,

Wu,

Zeng

et al. 2023

Diabetes Obesity Metabolism

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AimBariatric metabolic surgery (BMS) is a proven treatment option for patients with both obesity and type 2 diabetes mellitus (T2DM). However, there is a lack of comprehensive reporting on the short‐term remission rates of diabetes, and the existing data are inadequate. Hence, this study aimed to investigate the factors that may contribute to diabetes remission (DR) in patients with obesity and T2DM, 3 months after undergoing BMS. Furthermore, our objective was to develop a risk‐predicting model using a nomogram.MethodsIn total, 389 patients with obesity and T2DM, who had complete preoperative information and underwent either laparoscopic sleeve gastrectomy or laparoscopic gastric bypass surgery between January 2014 and May 2023, were screened in the Chinese Obesity and Metabolic Surgery Database. The patients were randomly divided into a training set (n = 272) and a validation set (n = 117) in a 7:3 ratio. Potential factors for DR were analysed through univariate and multivariate logistic regression analyses and then modelled using a nomogram. The model's performance was evaluated using receiver operating characteristic curves and the area under the curve (AUC). Calibration plots were used to assess prediction accuracy and decision curve analyses were conducted to evaluate the clinical usefulness of the model.ResultsGlycated haemoglobin, triglycerides, duration of diabetes, insulin requirement and hypercholesterolaemia were identified as independent factors influencing DR. We have incorporated these five indicators into a nomogram, which has shown good efficacy in both the training cohort (AUC = 0.930) and validation cohort (AUC = 0.838). The calibration plots indicated that the model fits well in both the training and the validation cohorts, and decision curve analyses showed that the model had good clinical applicability.ConclusionThe prediction model developed in this study holds predictive value for short‐term DR following BMS in patients with obesity and T2DM.

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Section: Discussionsupporting

confidence: 92%

Construction and validation of a nomogram for predicting diabetes remission at 3 months after bariatric surgery in patients with obesity combined with type 2 diabetes mellitus

Yuan,

Wu,

Zeng

et al. 2023

Diabetes Obesity Metabolism

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show abstract

“…Patients with type 2 diabetes mellitus (T2DM) show more immediate and significant improvements in insulin secretion after surgery compared to nondiabetic individuals, suggesting that bariatric procedures may specifically target and correct b-cell function abnormalities. Bariatric surgeries have shown significant improvement in long-term glucose homeostasis in patients with T2DM [55][56][57][58]. In nondiabetic individuals, insulin secretion closely follows glucose levels during oral glucose tolerance tests (OGTT) or mixed meal tolerance tests (MMTT) postsurgery, with a more dynamic response seen in RYGB and LSG than in biliopancreatic diversion, highlighting the role of ambient glycemia in shaping b-cell response to meals [59].…”

Section: Insulinmentioning

confidence: 99%

Gut motility and hormone changes after bariatric procedures

Gala,

Ghusn,

Abu Dayyeh

2024

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review Metabolic and bariatric surgery (MBS) and endoscopic bariatric therapies (EBT) are being increasingly utilized for the management of obesity. They work through multiple mechanisms, including restriction, malabsorption, and changes in the gastrointestinal hormonal and motility. Recent findings Roux-en-Y gastric bypass (RYGB) and laparoscopic sleeve gastrectomy (LSG) cause decrease in leptin, increase in GLP-1 and PYY, and variable changes in ghrelin (generally thought to decrease). RYGB and LSG lead to rapid gastric emptying, increase in small bowel motility, and possible decrease in colonic motility. Endoscopic sleeve gastroplasty (ESG) causes decrease in leptin and increase in GLP-1, ghrelin, and PYY; and delayed gastric motility. Summary Understanding mechanisms of action for MBS and EBT is critical for optimal care of patients and will help in further refinement of these interventions.

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The association between microvascular and macrovascular diseases and diabetes remission after bariatric surgery

Ghusn,

Salame,

Sayegh

et al. 2024

Surg Endosc

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The role of diabetes severity scores in predicting disease remission in patients with BMI > 50 kg/m2 undergoing Roux-En-Y gastric bypass and sleeve gastrectomy: a multi-centered study

Cited by 8 publications

References 20 publications

Construction and validation of a nomogram for predicting diabetes remission at 3 months after bariatric surgery in patients with obesity combined with type 2 diabetes mellitus

Construction and validation of a nomogram for predicting diabetes remission at 3 months after bariatric surgery in patients with obesity combined with type 2 diabetes mellitus

Gut motility and hormone changes after bariatric procedures

The association between microvascular and macrovascular diseases and diabetes remission after bariatric surgery

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