TITLE

Evolution of Type 2 Diabetes Mellitus in Non Morbid Obese Gastrectomized Patients with Roux en-Y Reconstruction: Retrospective Study

AUTHOR(S)
Lanzarini, Enrique; Csendes, Attila; Lembach, Hans; Molina, Juan; Gutiérrez, Luis; Silva, Johanna
PUB. DATE
September 2010
SOURCE
World Journal of Surgery;Sep2010, Vol. 34 Issue 9, p2098
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Bariatric surgery in morbidly obese patients with type 2 diabetes results systematically in adequate glycemic control, normalization of insulinemia, and a decrease in glycosylated hemoglobin, effects that appear early after surgery in nearly 80 to 90% of them. Possible reasons that have been discussed are a decrease in caloric consumption, weight loss, and hormonal changes at the gastrointestinal level, which could have a positive effect on glucose metabolism. Various authors have proposed the possibility of passing on this indication to diabetic patients who are overweight or are mildly obese. The purpose of this retrospective investigation was to determine the effect of total or subtotal gastrectomy with Roux-en-Y reconstruction on the metabolic control of patients with type 2 diabetes with a body mass index (BMI) < 35, operated on for reasons other than obesity. From January 1999 to December 2007, a total of 23 diabetic patients who underwent total or subtotal gastrectomy with a gastrojejunal or esphagojejunal anastomosis with Roux-en-Y reconstruction of 60 to 70 cm length were included in this investigation. The group consisted of 23 patients (14 men, 9 women, average age 62.9 ± 7.9 years, average BMI 29.1 ± 5.1). The principal reason for gastrectomy in these patients was gastric cancer in 19 patients (82.6%). The surgical procedure was total gastrectomy in 17 cases (73.9%) and subtotal gastrectomy in 6 cases (26.1%). Postoperative follow-up was 22 months. Before surgery the mean blood glucose level was 151.4 mg/dl. Late after surgery, 15 patients (65.2%) had a fasting blood glucose <126 mg/dl and are not using medication (remission), 7 (30.4%) patients have better metabolic control with a normal blood glucose but are still taking medication (improvement), and just 1 (4.3%) patient has an altered blood glucose and uses insulin (no change). Gastrectomy and short Roux-en-Y limb reconstruction in type 2 diabetes patients with BMI < 35, with the patients submitted to surgery mainly for gastric cancer, correlates with remission of diabetes in 65% and improvement in 30.4%.
ACCESSION #
52760333

 

Related Articles

  • Weight-HbA1c-insulin-glucose model for describing disease progression of type 2 diabetes. Choy, S; Kjellsson, MC; Karlsson, MO; de Winter, W // CPT: Pharmacometrics & Systems Pharmacology;Jan2016, Vol. 5 Issue 1, p11 

    A previous semi-mechanistic model described changes in fasting serum insulin (FSI), fasting plasma glucose (FPG), and glycated hemoglobin (HbA1c) in patients with type 2 diabetic mellitus (T2DM) by modeling insulin sensitivity and β-cell function. It was later suggested that change in body...

  • Effects of Genetic Susceptibility for Type 2 Diabetes on the Evolution of Glucose Homeostasis Traits Before and After Diabetes Diagnosis. Gautier, Alain; Roussel, Ronan; Lange, Céline; Piguel, Xavier; Cauchi, Stéphane; Vol, Sylviane; Froguel, Philippe; Balkau, Beverley; Bonnet, Fabrice // Diabetes;Oct2011, Vol. 60 Issue 10, p2654 

    OBJECTIVE-To assess the impact of genetic susceptibility on evolution toward type 2 diabetes (T2D) by analyzing time trajectories of fasting glucose, glycated hemoglobin (HbA1c), insulin sensitivity (homeostasis model assessment [HOMA2%S]), and β-cell secretion (HOMA2%B) in a large...

  • Insulin resistance and beta cell function before and after sleeve gastrectomy in obese patients with impaired fasting glucose or type 2 diabetes. Eickhoff, Hans; Guimarães, Ana; Louro, Teresa; Seiça, Raquel; Castro e Sousa, Francisco // Surgical Endoscopy;Feb2015, Vol. 29 Issue 2, p438 

    Background: Pathophysiology of type 2 diabetes (T2D) includes insulin resistance (IR) and insufficient insulin secretion. Remission in obese patients can be achieved through surgically induced weight loss. Sleeve gastrectomy is a novel technique for the treatment of morbid obesity, and its...

  • Opportunistic random blood glucose best.  // Pulse;4/7/2003, Vol. 63 Issue 14, p18 

    Reports that opportunistic random glucose testing for type 2 diabetes in obese patients is more worthwhile than fasting measurements, according o research in Tayside, Scotland, where diagnosed cases have soared by over 50% in five years.

  • Efecto de una guía de práctica clínica para el manejo de la diabetes tipo 2. Pérez-Cuevas, Ricardo; Reyes-Morales, Hortensia; Flores-Hernández, Sergio; Wacher-Rodarte, Niels // Revista Medica del IMSS;jul/ago2007, Vol. 45 Issue 4, p353 

    Objective: to evaluate the efficacy of a clinical practice guideline for treating type-2 diabetes patients in family medicine clinics. Material method: non randomized control trial that took place in two family medicine clinics. Patients with more than 10 years of being diabetic were included....

  • Does the length of the biliary limb influence medium-term laboratory remission of type 2 diabetes mellitus after Roux-en-Y gastric bypass in morbidly obese patients? Kaska, Łukasz; Kobiela, Jarek; Proczko, Monika; Stefaniak, Tomasz; Śledziński, Zbigniew // Videosurgery & Other Miniinvasive Techniques / Wideochirurgia i;Mar2014, Vol. 2014 Issue 1, p31 

    Introduction: The Roux-en-Y gastric bypass (RYGB) is an effective treatment of morbid obesity leading to type 2 diabetes mellitus (T2DM) resolution. However, evidence demonstrates that standard limb lengths can have a limited impact on long-term weight loss and durable T2DM remission. Aim: The...

  • Amelioration of Glycemic Control by Sleeve Gastrectomy and Gastric Bypass in a Lean Animal Model of Type 2 Diabetes: Restoration of Gut Hormone Profile. Eickhoff, Hans; Louro, Teresa; Matafome, Paulo; Vasconcelos, Filipa; Seiça, Raquel; Castro e Sousa, Francisco // Obesity Surgery;Jan2015, Vol. 25 Issue 1, p7 

    Background: In obese diabetic patients, bariatric surgery has been shown to induce remission of type 2 diabetes. Along with weight loss itself, changes in gut hormone profiles after surgery play an important role in the amelioration of glycemic control. However, the potential of gastrointestinal...

  • Prevention of type 2 diabetes in obese at-risk subjects: a systematic review and meta-analysis. Merlotti, Claudia; Morabito, Alberto; Ceriani, Valerio; Pontiroli, Antonio // Acta Diabetologica;Oct2014, Vol. 51 Issue 5, p853 

    Different intervention strategies can prevent new cases of type 2 diabetes (T2DM) in obese subjects. The present systematic review and meta-analysis evaluates the effectiveness of different strategies in prevention of type 2 diabetes in obese subjects. Studies were grouped into five different...

  • Bariatric Surgery versus Intensive Medical Therapy in Obese Patients with Diabetes. Schauer, Philip R.; Kashyap, Sangeeta R.; Wolski, Kathy; Brethauer, Stacy A.; Kirwan, John P.; Pothier, Claire E.; Thomas, Susan; Abood, Beth; Nissen, Steven E.; Bhatt, Deepak L. // New England Journal of Medicine;4/26/2012, Vol. 366 Issue 17, p1567 

    Background: Observational studies have shown improvement in patients with type 2 diabetes mellitus after bariatric surgery. Methods: In this randomized, nonblinded, single-center trial, we evaluated the efficacy of intensive medical therapy alone versus medical therapy plus Roux-en-Y gastric...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics