Thirty‐Day Morbidity and Mortality of the Laparoscopic Ileal Interposition Associated with Sleeve Gastrectomy for the Treatment of Type 2 Diabetic Patients with BMI &lt;35: An Analysis of 454 Consecutive Patients

DePaula, Aureo L.; Stival, Alessandro R.; Halpern, Alfredo; Vencio, Sérgio

doi:10.1007/s00268-010-0799-3

Cited by 32 publications

(9 citation statements)

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“…It is important to note that this manuscript is not an assessment of the surgical procedure’s safety, which has already been evaluated in an analysis of 454 cases [30], nor the efficacy or its acceptability profile, as these data had been previously evaluated in a prospective randomized controlled trial [31]. We also recognize that this is not a routine surgical procedure and that it has been performed in selected centers [32,33].…”

Section: Discussionmentioning

confidence: 99%

Early Mechanisms of Glucose Improvement following Laparoscopic Ileal Interposition Associated with a Sleeve Gastrectomy Evaluated by the Euglycemic Hyperinsulinemic Clamp in Type 2 Diabetic Patients with BMI below 35

Vencio

Stival²,

Halpern³

et al. 2011

Dig Surg

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Background: Laparoscopic ileal interposition associated with a sleeve gastrectomy (LII-SG) is a safe and effective operation for the treatment of type 2 diabetic (T2DM) patients with BMI below 35. The aim of this study was to evaluate insulin sensitivity (IS) and β-cell function using the euglycemic hyperinsulinemic clamp (EHC) with the intravenous glucose tolerance test (IVGTT). Methods: This was a prospective study of 24 T2DM patients submitted to a 3-hour EHC-IVGTT before and 1 month after LII-SG. Mean BMI was 29.0, mean age was 54.8 years and mean duration of T2DM was 10.2 years; insulin therapy was used by 62.5% of the patients. Results: Mean BMI decreased from 29.0 to 25.8 (p < 0.001). Mean fasting plasma glucose and mean postprandial glucose were 202 and 251.3 mg/dl and dropped to 127.7 and 131.8 mg/dl (p < 0.001), respectively. Mean preoperative IS was 1.4 mmol·min^–1·nmol^–1 and increased to 2.2 mmol· min^–1·nmol^–1 postoperatively (p < 0.001). Mean C-peptide AUC was 488 pmol·nmol^–1 and increased to 777 pmol· nmol^–1 (p = 0.37). The disposition index increased from 9.4 to 36.4 postoperatively (p = 0.01). Conclusions: According to the clamp technique, II-SG significantly improved IS and β-cell function as early as 30 days postoperatively in a T2DM population with a BMI of 21.9–33.8.

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Section: Discussionmentioning

confidence: 99%

Early Mechanisms of Glucose Improvement following Laparoscopic Ileal Interposition Associated with a Sleeve Gastrectomy Evaluated by the Euglycemic Hyperinsulinemic Clamp in Type 2 Diabetic Patients with BMI below 35

Vencio

Stival²,

Halpern³

et al. 2011

Dig Surg

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“…One solution to this problem is oral rehydration therapy which is an effective treatment for GGM, where sodium and glucose are combined with water for intestinal absorption by direct co-transport and sodium/glucoseinduced osmosis, the latter resulting from sodium and glucose co-transport via SGLT1 in the apical membrane of the enterocytes. 15 Firstly, in patients with uncontrolled diabetes, SGLT1 plays an important role in the intestinal absorption and the renal reabsorption of glucose, especially those receiving SGLT2 inhibitors. As a result, there is an interesting therapeutic option in patients with diabetes which is inhibition of SGLT1 transporters.…”

Section: Clinical Significancementioning

confidence: 99%

Effect of SGLT in Type 2 Diabetes and Gastric Bypass Surgery - A Narrative Review

Shoaib¹,

Dwivedi²,

Ren³

et al. 2019

IJCMR

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Body fat is regulated by a complex neuroendocrine system, making it difficult to maintain weight loss achieved via caloric restriction. Bariatric surgery produces greater weight loss and weight loss that is more durable than caloric restriction, and therefore is currently the most effective therapy for obesity. Sodium-glucose-co-transporter inhibitors are glucose lowering drugs that reduces plasma glucose levels by inhibiting glucose and sodium reabsorption in the kidneys, resulting in glycosuria. Sleeve gastrectomy is one such bariatric surgical procedure that involves the creation of a reduced stomach lumen along the lesser curvature of the stomach through the removal of gastric tissues along the greater curvature from the fundus to the antrum. Stomach capacity is typically reduced 80% or more, and the intestine remains intact. This procedure produces dramatic weight loss in humans and in rodents. In fact, recent reports indicate that its efficacy is close to that of the more common Roux-en Y gastric bypass. There are many diverse factors on which operative mortality of bariatric surgery depends such as facility related, surgeon related, followed by patient and procedure-related. To minimize operative mortality, specific factors were considered for the specific patients. As a result, to treat type 2 diabetes in association with obesity, slightly obese patients or overweight patients were treated with conventional bariatric procedures worldwide. For the management of morbidity obese diabetic patients, there is no single or standard procedure. Mahmood. Effect of SGLT in type 2 diabetes and gastric bypass surgery -a narrative review.

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“…По мере накопления данных стало очевидным, что частота интраоперационных и ранних послеоперационных осложнений при ИТ-ПРЖ сопоставима с другими стандартными бариатрическими операциями. Так, если после ИТ-ПРЖ количество ослож-нений колеблется от 0 до 6,4% [37,38,47], то этот показатель после сопоставимой по сложности операции лапароскопи-ческого МГШ составил 5,5-6,0% [48]. Сохранение общей протяженности ЖКТ при ИТ позволяет избежать в отда-ленном послеоперационном периоде типичных для шун-тирующих операций осложнений, связанных с дефицитом витаминов и нутриентов, что может сделать ИТ более пер-спективной операцией для лечения больных СД2 без вы-раженного ожирения.…”

Section: заключениеunclassified

Ileal transposition in surgical treatment for type 2 diabetes mellitus

et al. 2015

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Введениенастоящее время сахарный диабет 2 типа (СД2) яв-ляется широко распространенным заболеванием, а эксперты ВОЗ рассматривают сло жившуюся ситуацию как пандемию. В 2010 г. в мире насчитыва-лось 285 млн взрослых больных сахарным диабетом (СД), а в России -3,16 млн. Учитывая динамику заболеваемо-сти и смертности за последние 10 лет, ожидается увеличе-ние заболеваемости СД в мире с 6,4% до 7,7%. При этом к 2030 г. прогнозируется увеличение числа зарегистриро-ванных больных СД до 439 млн человек в мире и до 5,81 млн человек в России [1,2]. Социальную значимость проблемы увеличивает то обстоятельство, что СД приводит к ран-ней инвалидизации и смертности в связи с фатальными сосудистыми осложнениями. Несмотря на проведение адекватной лекарственной терапии, показатели гликемиче-ского контроля (в том числе, содержание гликированного гемоглобина -HbA 1c ) у пациентов с СД зачастую не нор-мализуются, что связано с прогрессирующим нарушением функции β-клеток поджелудочной железы [3].Наряду с консервативной терапией, для лечения СД2 с сопутствующим ожирением сегодня уже используются бариатрические операции. Данное направление хирур-гии, изначальной целью которого являлось снижение массы тела у пациентов с морбидным первичным ожире-нием, начало формироваться в 50-х годах прошлого века. По мере развития бариатрической хирургии были вы-явлены положительные эффекты проводимых операций на сопутствующие ожирению заболевания, а именно, СД2, дислипидемию и артериальную гипертензию. Поло-жительное влияние операции гастрошунтирования (ГШ)

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Thirty‐Day Morbidity and Mortality of the Laparoscopic Ileal Interposition Associated with Sleeve Gastrectomy for the Treatment of Type 2 Diabetic Patients with BMI <35: An Analysis of 454 Consecutive Patients

Abstract: The laparoscopic ileal interposition associated with a sleeve gastrectomy was considered a safe operation with low rates of morbidity and mortality in a diabetic population with BMI < 35. An early control of postprandial glycemia was observed.

Cited by 32 publications

References 41 publications

Early Mechanisms of Glucose Improvement following Laparoscopic Ileal Interposition Associated with a Sleeve Gastrectomy Evaluated by the Euglycemic Hyperinsulinemic Clamp in Type 2 Diabetic Patients with BMI below 35

Early Mechanisms of Glucose Improvement following Laparoscopic Ileal Interposition Associated with a Sleeve Gastrectomy Evaluated by the Euglycemic Hyperinsulinemic Clamp in Type 2 Diabetic Patients with BMI below 35

Effect of SGLT in Type 2 Diabetes and Gastric Bypass Surgery - A Narrative Review

Ileal transposition in surgical treatment for type 2 diabetes mellitus

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