Sleeve Gastrectomy and Roux-en-Y Gastric Bypass Achieve Similar Early Improvements in Beta-cell Function in Obese Patients with Type 2 Diabetes

Autor:	Gerardo Febres, Marc Bessler, Judith Korner, Jamie A. Mullally
Jazyk:	angličtina
Rok vydání:	2019
Předmět:	Adult Blood Glucose Male 0301 basic medicine medicine.medical_specialty Sleeve gastrectomy Adolescent medicine.medical_treatment Gastric Bypass lcsh:Medicine Type 2 diabetes Gastroenterology Article Body Mass Index Young Adult 03 medical and health sciences 0302 clinical medicine Gastrectomy Weight loss Insulin-Secreting Cells Diabetes mellitus Internal medicine Weight Loss Humans Medicine Obesity lcsh:Science Aged Glucose tolerance test Multidisciplinary medicine.diagnostic_test business.industry Insulin lcsh:R nutritional and metabolic diseases Glucose Tolerance Test Middle Aged medicine.disease Roux-en-Y anastomosis Treatment Outcome 030104 developmental biology Diabetes Mellitus Type 2 Female lcsh:Q medicine.symptom business 030217 neurology & neurosurgery
Zdroj:	Scientific Reports, Vol 9, Iss 1, Pp 1-7 (2019) Scientific Reports
ISSN:	2045-2322
Popis:	Bariatric surgery is a treatment option for obese patients with type 2 diabetes mellitus (T2DM). Although sleeve gastrectomy (SG) is growing in favor, some randomized trials show less weight loss and HbA1c improvement compared with Roux-en-Y gastric bypass (RYGB). The study objective was to compare changes in beta-cell function with similar weight loss after SG and RYGB in obese patients with T2DM. Subjects undergoing SG or RYGB were studied with an intravenous glucose tolerance test before surgery and at 5–12% weight loss post-surgery. The primary endpoint was change in the disposition index (DI). Baseline BMI, HbA1c, and diabetes-duration were similar between groups. Mean total weight loss percent was similar (8.4% ± 0.4, p = 0.22) after a period of 21.0 ± 1.7 days. Changes in fasting glucose, acute insulin secretion (AIR), and insulin sensitivity (Si) were similar between groups. Both groups showed increases from baseline to post-surgery in DI (20.2 to 163.3, p = 0.03 for SG; 31.2 to 232.9, p = 0.02 for RYGB) with no significant difference in the change in DI between groups (p = 0.53). Short-term improvements in beta-cell function using an IVGTT were similar between SG and RYGB. It remains unclear if longer-term outcomes are better after RYGB due to greater weight loss and/or other factors.
Databáze:	OpenAIRE
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