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Gastric bypass diabetes mellitus type 2

Sharon Grundfest-Broniatowski, JingLiang Yan, Matthew Kroh, Holly Kilim, Andrew Stephenson
Familial partial lipodystrophy type 2 (FPLD2) is a rare disorder associated with LMNA gene mutations. It is usually marked by loss of subcutaneous fat on the limbs and trunk and severe insulin resistance. Scattered reports have indicated that Roux-en-Y bypass helps to control the diabetes mellitus in these patients. We present here a very unusual patient with FPLD2 who had life-threatening retroperitoneal and renal fat accumulation accompanied by bilateral renal cancers. Following cryotherapy of one renal cancer and a contralateral nephrectomy with debulking of the retroperitoneal fat, Roux-en-Y gastric bypass (RYGB) has successfully controlled the disease for 3 years...
October 24, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Saeed Shoar, Alan A Saber
OBJECTIVE: This study aimed to compare midterm and long-term weight loss and resolution of co-morbidity with laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic sleeve gastrectomy (LSG). SUMMARY: LRYGB and LSG are the most common procedures performed in bariatric surgery. However, their weight loss efficacy in the midterm and long-term has not been well compared. METHODS: A meta-analysis was performed by systematically identifying comparative studies conducted until the end of June 2016 that investigated weight loss outcome and resolution of co-morbidities (type 2 diabetes mellitus, hypertension, hyperlipidemia, hypertriglyceridemia, and obstructive sleep apnea) with LRYGB and LSG in the midterm (3-5 years) and long term (≥5 years)...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Guohui Wang, Liyong Zhu, Weizheng Li, Xiangwu Yang, Pengzhou Li, Shaihong Zhu
BACKGROUND: The efficacy of laparoscopic Roux-en-Y gastric bypass (LRYGB) in type 2 diabetes mellitus (T2D) is closely associated with the preoperative body mass index (BMI) of the patient. There is a lack of long-term and large sampling evidence on the efficacy of LRYGB in T2D patients with low BMI in China. OBJECTIVES: This retrospective study aimed to evaluate the efficacy of surgical treatment in a Chinese population with T2D (especially patients with BMI<27...
July 12, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Josemberg Campos, Almino Ramos, Thomaz Szego, Bruno Zilberstein, Heládio Feitosa, Ricardo Cohen
Introduction: Even considering the advance of the medical treatment in the last 20 years with new and more effective drugs, the outcomes are still disappointing as the control of obesity and type 2 Diabetes Mellitus (T2DM) with a large number of patients under the medical treatment still not reaching the desired outcomes. Objective: To present a Metabolic Risk Score to better guide the surgical indication for T2DM patients with body mass index (BMI) where surgery for obesity is still controversial...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Cátia Ferreira da Silva, Larissa Cohen, Luciana d'Abreu Sarmento, Felipe Monnerat Marino Rosa, Eliane Lopes Rosado, João Régis Ivar Carneiro, Antônio Augusto Peixoto de Souza, Fernanda Cristina Carvalho Mattos Magno
Background: Due to the high failure rate observed in the clinical treatment of morbid obesity an increase in bariatric surgery indications, as an alternative for the control of obesity and comorbidities, is noticeable. Aim: To evaluate the performance of type 2 diabetes mellitus, high blood pressure and dyslipidemia in patients submitted to Roux-en-Y gastric bypass in late follow-up. Methods: Retrospective analysis of 59 patients included in the bariatric surgery program...
2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Chelsea R Hutch, Darleen A Sandoval
Bariatric surgery is currently the most effective treatment for obesity and associated comorbidities, including rapid resolution of type 2 diabetes mellitus (T2DM). Although the weight loss itself has substantial impact, bariatric surgery also has weight loss-independent effects on T2DM. Several variations of bariatric surgery exist, including the widely studied Roux-en-Y gastric bypass and vertical sleeve gastrectomy. The success of both of these bariatric surgeries was originally attributed to restrictive and malabsorptive modes of action; however, mounting evidence from both human and animal studies implicates mechanisms beyond surgery-induced mechanical changes to the gastrointestinal (GI) system...
September 26, 2016: Annals of the New York Academy of Sciences
Yosuke Seki, Kazunori Kasama, Hidenori Haruta, Atsushi Watanabe, Renzo Yokoyama, Jose Paolo Cabreira Porciuncula, Akiko Umezawa, Yoshimochi Kurokawa
BACKGROUND: Laparoscopic sleeve gastrectomy with duodenojejunal bypass (LSG-DJB) has been designated as a novel bariatric surgery procedure. This combination of sleeve gastrectomy and proximal intestinal bypass theoretically offers an effective and prolonged anti-diabetes effect. This is a follow-up of our institution's previous report on the short-term effects of LSG-DJB on type 2 diabetes mellitus (T2DM), which a 68.7 % remission (HbA1c <6 % without diabetes medication) rate 1 year after surgery...
September 19, 2016: Obesity Surgery
A Van Gossum, L Pironi, C Chambrier, M Dreesen, C F Brandt, L Santarpia, F Joly
BACKGROUND & AIMS: Obesity is a worldwide health problem. Bariatric surgery (BS) is becoming one of the most commonly used methods for fighting obesity and its associated comorbidities. However, current BS techniques can be associated with early or late complications that may require nutritional support. The aim of this retrospective observational study was to determine the indications and outcomes for patients on Home parenteral nutrition (HPN) due to post-bariatric surgery complications...
September 8, 2016: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Hidenori Haruta, Kazunori Kasama, Masayuki Ohta, Akira Sasaki, Hiroshi Yamamoto, Yasuhiro Miyazaki, Takashi Oshiro, Takeshi Naitoh, Yoshinori Hosoya, Takeshi Togawa, Yosuke Seki, Alan Kawarai Lefor, Toru Tani
BACKGROUND: The number of bariatric procedures performed in Japan is increasing. There are isolated reports of bariatric surgery, but there have been no nationwide surveys including long-term data. METHODS: We retrospectively reviewed data for patients who underwent bariatric and metabolic surgery throughout Japan and reviewed outcomes. Surveys were sent to ten institutions for number of procedures, preoperative patient weight and preoperative obesity-related comorbidities, and data at 1, 3, and 5 years postoperatively...
September 8, 2016: Obesity Surgery
George Tharakan, Rebecca Scott, Olivia Szepietowski, Alexander D Miras, Alexandra I Blakemore, Sanjay Purkayastha, Ahmed Ahmed, Harvinder Chahal, Tricia Tan
PURPOSE: This study aimed to determine the predictive power of the DiaRem score following Roux-en-Y gastric bypass to identify patients who would have diabetes remission at 1 year in an ethnically diverse population. METHODS: We performed a retrospective review of 262 patients with type 2 diabetes mellitus who underwent RYGB at the Imperial Weight Centre, UK, from 2007 to 2014. Data was collected on the parameters required to calculate the DiaRem score as well as pre- and post-surgical weight and the ethnicity of the subjects...
September 10, 2016: Obesity Surgery
B Stratmann, Y Krepak, E Schiffer, I Jarick, M Hauber, Y H Lee-Barkey, M Fischer, D Tschoepe
Implantation of a duodenal-jejunal endoluminal bypass liner (DJBL) has shown to induce weight loss and to improve metabolic parameters. DJBL is a reversible endoduodenal sleeve mimicking duodenal bypass while lacking risks and limitations of bariatric surgery.Effects on metabolic control, body mass parameters, appetite regulation, glucose tolerance, organ health, and lipid profile were determined in 16 morbidly overweight patients with type 2 diabetes mellitus. In addition, relevant hormones (leptin, ghrelin, gastric inhibitory peptide, glucagon-like peptide, and insulin) were measured by enzyme-linked immunosorbent assay (ELISA) and chemiluminescent microparticle immunoassay (CMIA) at 0, 1, 32, and 52 weeks post-implant following a mixed meal tolerance test...
September 2016: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
Steven K Malin, Sangeeta R Kashyap
Bariatric surgery is a gastrointestinal procedure that has emerged as the most effective treatment for weight loss. Roux-en-Y gastric bypass and sleeve gastrectomy are the main procedures currently performed. However, the benefits of bariatric surgery extend beyond weight loss. In fact, improvements in β-cell function occur before clinically meaningful weight loss and contribute to type 2 diabetes mellitus (T2D) remission. Herein, we discuss evidence supporting the efficacy of bariatric surgery for weight loss and improved insulin secretion in patients with and without T2D...
July 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Alper Celik, Sjaak Pouwels, Fatih Can Karaca, Eylem Çağıltay, Surendra Ugale, İlker Etikan, Deniz Büyükbozkırlı, Yunus Emre Kılıç
BACKGROUND: Medical treatment fails to provide adequate control for many obese patients with type 2 diabetes mellitus (T2DM). A comparative observational study of bariatric procedures was performed to investigate the time at which patients achieve glycemic control within the first 30 postoperative days following sleeve gastrectomy (SG), mini-gastric bypass (MGB), and diverted sleeve gastrectomy with ileal transposition (DSIT). METHODS: Included patients had a body mass index (BMI) ≥30 kg/m(2); T2DM for ≥3 years, HbA1C > 7 % for ≥3 months, and no significant weight change (>3 %) within the prior 3 months...
August 26, 2016: Obesity Surgery
Marcelo Gomes Girundi
OBJECTIVE: to evaluate the effectiveness of Roux-en-Y gastric bypass in improving the glycemic profile of obese patients with type 2 Diabetes Mellitus (DM2) after 18 months of follow-up. METHODS: four hundred sixty-eight pacients with DM2 and BMI ≥35 were submitted to Roux-en-Y gastric bypass, from 1998 to 2010. All patients were submitted to glycemic control analysis in the 3rd, 6th, 9th, 12th and 18th postoperative months. We considered: type 2 diabetic patients, the ones with fasting glucose ≥126mg/dl and HbA1C ≥6...
May 2016: Revista do Colégio Brasileiro de Cirurgiões
Wei-Jei Lee, Keong Chong, Lwin Aung, Shu-Chun Chen, Kong-Han Ser, Yi-Chih Lee
BACKGROUND: Bariatric surgery has gained reputation for its metabolic effect and is increasingly being performed to treat type 2 diabetes mellitus (T2DM). However, there is still a gray area regarding the choice of surgical procedure according to patient characteristics due to inadequate evidences, so far. We aim to compare the efficacy of two most commonly performed bariatric/metabolic surgeries, sleeve gastrectomy (SG) and gastric bypass (GB) with regard to remission of T2DM after surgery...
August 22, 2016: World Journal of Surgery
Dan Ding, Chengzhu Zheng
Obesity and type 2 diabetes mellitus have already become one of the most serious society-facing problems. Since the first report in the 1950s, gastrointestinal surgery has greatly developed as the golden standard in obesity treatment. With the convincing research and evidence, it is found that gastrointestinal surgery not only can cause weight loss, but can relieve, even cure many metabolic diseases associated with obesity, especially for type 2 diabetes mellitus. The operational manners, including adjustable gastric banding, Roux-en-Y gastric bypass, mini gastric bypass, sleeve gastrectomy, etc...
August 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Thomas Bächler, Carel W le Roux, Marco Bueter
Bariatric surgery is currently the most effective option for the treatment of morbid obesity and its associated comorbidities. Recent clinical and experimental findings have challenged the role of mechanical restriction and caloric malabsorption as the main mechanisms for weight loss and health benefits. Instead, other mechanisms including increased levels of satiety gut hormones, altered gut microbiota, changes in bile acid metabolism, and/or energy expenditure have been proposed as explanations for benefits of bariatric surgery...
2016: Clinical and Experimental Gastroenterology
Ivy N Haskins, Ricard Corcelles, Dvir Froylich, Mena Boules, Amani Hag, Bartolome Burguera, Phillip R Schauer, Matthew Kroh, Stacy A Brethauer
BACKGROUND: It is well accepted that bariatric surgery has cardiovascular and metabolic effects independent of weight loss. METHODS: Weight loss outcomes of patients undergoing Roux-en-Y gastric bypass (RYGB) at a high volume referral center were collected at 1 year postoperatively. Patients with failed primary weight loss were identified. Primary inadequate weight loss was defined as total body weight loss less than 15 %. Changes in hypertension (HTN), dyslipidemia, type 2 diabetes mellitus (T2DM), and metabolic syndrome profiles were investigated using Student's t test...
August 10, 2016: Obesity Surgery
Xianhui Xu, Jianli Wang, Ling Li, Chunbin Wang, Weihua Li, Qin Zhang, Linghui Yang
AIMS: Roux-en-Y gastric bypass (RYGB) is a novel therapy for diabetes and the exact mechanisms of this procedure remain unclear. Obestatin is an important gut hormone. We aimed to explore the role of obestatin in the therapeutic mechanism of RYGB. METHODS: Twenty obese Zucker rats and twenty Wistar rats were randomly assigned to two groups: RYGB and sham surgery. We evaluated plasma obestatin and insulin levels pre- and post-RYGB. Additionally, obestatin expression levels in the gastrointestinal tract were assessed using immunohistochemical staining...
September 2016: Diabetes Research and Clinical Practice
Magnus Sundbom, Jakob Hedberg, Richard Marsk, Lars Boman, Ami Bylund, Jan Hedenbro, Anna Laurenius, Göran Lundegårdh, Peter Möller, Torsten Olbers, Johan Ottosson, Ingmar Näslund, Erik Näslund
OBJECTIVE: To evaluate effect on comorbid disease and weight loss 5 years after Roux-en-Y gastric bypass (RYGB) surgery for morbid obesity in a large nationwide cohort. BACKGROUND: The number patients having surgical procedures to treat obesity and obesity-related disease are increasing. Yet, population-based, long-term outcome studies are few. METHODS: Data on 26,119 individuals [75.8% women, 41.0 years, and body mass index (BMI) 42.8 kg/m] undergoing primary RYGB between May 1, 2007 and June 30, 2012, were collected from 2 Swedish quality registries: Scandinavian Obesity Surgery Registry and the Prescribed Drug Registry...
July 15, 2016: Annals of Surgery
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