Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes

Mingrone, Geltrude; Panunzi, Simona; Gaetano, Andrea De; Guidone, Caterina; Iaconelli, Amerigo; Leccesi, Laura; Nanni, Giuseppe; Pomp, Alfons; Castagneto, Marco; Ghirlanda, Giovanni; Rubino, Francesco

doi:10.1056/nejmoa1200111

Cited by 1,635 publications

(1,058 citation statements)

References 26 publications

(31 reference statements)

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“…Both surgical procedures resulted in greater improvement in other CVD risk factors, including triglycerides and HDL-C, compared with intensive medical therapy. Two other RCTs in patients with obesity and type 2 diabetes mellitus consisting of 60 102 and 120 103 patients demonstrated similar results. All 4 RCTs showed that surgery in the short term (1-2 years) was well tolerated, with few major complications, and resulted in both superior glycemic control and greater improvements in CVD risk factors compared with medical treatment alone in up to 24 months of follow-up.…”

Section: Effect Of Surgery On Glycemic Control Cvd Risk Factors Andsupporting

confidence: 54%

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

Fox¹,

Golden²,

Anderson³

et al. 2015

Circulation

334

131

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Abstract-Cardiovascular disease risk factor control as primary prevention in patients with type 2 diabetes mellitus has changed substantially in the past few years. The input provided by Drs Fox, Ershow, Nelson, and Fradkin is from their own perspective, and the opinions expressed in this article do not reflect the view of the National Institutes of Health, Department of Health and Human Services, or the US government. Dr Pignone is a member of the US Preventive Services Task Force. His contributions here represent his views alone and not necessarily those of the US Preventive Services Task Force.The American Heart Association and the American Diabetes Association make every effort to avoid any actual or potential conflicts of interest that may arise as a result of an outside relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are required to complete and submit a Disclosure Questionnaire showing all such relationships that might be perceived as real or potential conflicts of interest.This document was approved by the American Heart Association Science Advisory and Coordinating Committee on April 30, 2015, the American Heart Association Executive Committee on May 22, 2015, and the American Diabetes Association on January 7, 2015.The American Heart Association requests that this document be cited as follows: Fox CS, Golden SH, Anderson C, Bray GA, Burke LE, de Boer IH, Deedwania P, Eckel RH, Ershow AG, Fradkin J, Inzucchi SE, Kosiborod M, Nelson RG, Patel MJ, Pignone M, Quinn L, Schauer PR, Selvin E, Vafiadis DK; on behalf of the American Heart Association Diabetes Committee of the Council on Lifestyle and Cardiometabolic Health, Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, Council on Quality of Care and Outcomes Research, and the American Diabetes Association. Update on prevention of cardiovascular disease in adults with type 2 diabetes mellitus in light of recent evidence: a scientific statement from the American Heart Association and the American Diabetes Association. Circulation. 2015;132:691-718. This article has been copublished in Diabetes Care.Copies: This document is available on the World Wide Web sites of the American Heart Association (my.americanheart.org) and the American Diabetes Association (www.diabetes.org). A copy of the document is available at http://my.americanheart.org/statements by selecting either the "By Topic" link or the "By Publication Date" link. To purchase additional reprints, call 843-216-2533 or e-mail kelle.ramsay@wolterskluwer.com.Expert peer review of AHA Scientific Statements is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit http://my.americanheart.org/statements and select the "Policies and Development" link.

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Section: Effect Of Surgery On Glycemic Control Cvd Risk Factors Andsupporting

confidence: 54%

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

Fox¹,

Golden²,

Anderson³

et al. 2015

Circulation

334

131

View full text Add to dashboard Cite

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“…A meta-analysis of observational studies of bariatric surgery involving 3188 patients with T2DM has reported that 78% had normalization of blood glucose in the absence of medications (14). However, available randomized trials are still very few and of limited size and duration (15,16). Furthermore, some recent observational studies have suggested caution about the benefits of bariatric surgery, showing no improvement in mortality when compared with standard care (17) and a high rate of long-term surgical complications especially for laparoscopic gastric banding procedures (18).…”

Section: Introductionmentioning

confidence: 99%

Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis

Corona

Rastrelli

Monami

et al. 2013

European Journal of Endocrinology

346

290

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Objective: Few randomized clinical studies have evaluated the impact of diet and physical activity on testosterone levels in obese men with conflicting results. Conversely, studies on bariatric surgery in men generally have shown an increase in testosterone levels. The aim of this study is to perform a systematic review and meta-analysis of available trials on the effect of body weight loss on sex hormones levels. Design: Meta-analysis. Methods: An extensive Medline search was performed including the following words: 'testosterone', 'diet', 'weight loss', 'bariatric surgery', and 'males'. The search was restricted to data from January 1, 1969 up to August 31, 2012. Results: Out of 266 retrieved articles, 24 were included in the study. Of the latter, 22 evaluated the effect of diet or bariatric surgery, whereas two compared diet and bariatric surgery. Overall, both a lowcalorie diet and bariatric surgery are associated with a significant (P!0.0001) increase in plasma sex hormone-binding globulin-bound and -unbound testosterone levels (total testosterone (TT)), with bariatric surgery being more effective in comparison with the low-calorie diet (TT increase: 8.73 (6.51-10.95) vs 2.87 (1.68-4.07) for bariatric surgery and the low-calorie diet, respectively; both P!0.0001 vs baseline). Androgen rise is greater in those patients who lose more weight as well as in younger, non-diabetic subjects with a greater degree of obesity. Body weight loss is also associated with a decrease in estradiol and an increase in gonadotropins levels. Multiple regression analysis shows that the degree of body weight loss is the best determinant of TT rise (BZ2.50G0.98, PZ0.029). Conclusions: These data show that weight loss is associated with an increase in both bound and unbound testosterone levels. The normalization of sex hormones induced by body weight loss is a possible mechanism contributing to the beneficial effects of surgery in morbid obesity.

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“…Also, it has a positive cost-benefit economic balance [6]. Moreover, a prospective study by Mingrone et al [7] has recently demonstrated that medical therapy, combined with bariatric surgery, controls glycaemic levels in more patients than medical therapy itself. In light of these findings, the Centres for Medicare and Medicaid Service (CMS), the American Diabetes Association (ADA), and IDF position statement [8] endorse bariatric surgery as the most effective treatment for obesity and several associated co-morbidities, such as type 2 diabetes mellitus [3].…”

Section: Introductionmentioning

confidence: 99%

Remisja cukrzycy typu 2 po leczeniu bariatrycznym — porównanie różnych procedur

Fernández-Soto¹,

Martín-Leyva²,

González-Jiménez³

et al. 2017

Endokrynologia Polska

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Introduction: We aimed to assess the mid-term type 2 diabetes mellitus recovery patterns in morbidly obese patients by comparing some relevant physiological parameters of patients of bariatric surgery between two types of surgical procedures: mixed (roux-en-Y gastric bypass and biliopancreatic diversion) and restrictive (sleeve gastrectomy). Material and methods: This is a prospective and observational study of co-morbid, type 2 diabetes mellitus evolution in 49 morbidly obese patients: 37 underwent mixed surgery procedures and 12 a restrictive surgery procedure. We recorded weight, height, body mass index, and glycaemic, lipid, and nutritional blood parameters, prior to procedure, as well as six and twelve months post-operatively. In addition, we tested for differences in patient recovery and investigated predictive factors in diabetes remission. Results: Both glycaemic and lipid profiles diminished significantly to healthy levels by 6 and 12 months post intervention. Type 2 diabetes mellitus showed remission in more than 80% of patients of both types of surgical procedures, with no difference between them. Baseline body mass index, glycated haemoglobin, and insulin intake, among others, were shown to be valuable predictors of diabetes remission one year after the intervention. Conclusions:The choice of the type of surgical procedure did not significantly affect the remission rate of type 2 diabetes mellitus in morbidly obese patients. (Endokrynol Pol 2017; 68 (1): 18-25)

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Bariatric Surgery versus Conventional Medical Therapy for Type 2 Diabetes

Cited by 1,635 publications

References 26 publications

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence

Body weight loss reverts obesity-associated hypogonadotropic hypogonadism: a systematic review and meta-analysis

Remisja cukrzycy typu 2 po leczeniu bariatrycznym — porównanie różnych procedur

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