Glycemic control after stomach-sparing duodenal-jejunal bypass surgery in diabetic patients with low body mass index

Cohen, Ricardo; Caravatto, Pedro Paulo de Paris; Correa, José Luis; Noujaim, Patrícia Malvina; Petry, Tarissa; Salles, João Eduardo Nunes; Schiavon, Carlos A.

doi:10.1016/j.soard.2012.01.017

Cited by 44 publications

(26 citation statements)

References 28 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In Goto-Kakizaki rats, a rodent model of nonobese type 2 diabetes, DJB improved glycemic control in as little as 1 week postoperatively, with no changes in body weight (62). Rapid weight-independent improvements in glycemia are also consistent with DJB in nonobese or mild obese type 2 diabetic humans (63)(64)(65)(66). These studies suggest that the rearrangement of the intestinal tract mediates the glucose-lowering effects of DJB.…”

Section: Jejunal Nutrient Sensingmentioning

confidence: 75%

Hormonal Signaling in the Gut

Côté

Zadeh-Tahmasebi

Rasmussen

et al. 2014

Journal of Biological Chemistry

View full text Add to dashboard Cite

The gut is anatomically positioned to play a critical role in the regulation of metabolic homeostasis, providing negative feedback via nutrient sensing and local hormonal signaling. Gut hormones, such as cholecystokinin (CCK) and glucagon-like peptide-1 (GLP-1), are released following a meal and act on local receptors to regulate glycemia via a neuronal gut-brain axis. Additionally, jejunal nutrient sensing and leptin action are demonstrated to suppress glucose production, and both are required for the rapid antidiabetic effect of duodenal jejunal bypass surgery. Strategies aimed at targeting local gut hormonal signaling pathways may prove to be efficacious therapeutic options to improve glucose control in diabetes.

show abstract

Section: Jejunal Nutrient Sensingmentioning

confidence: 75%

Hormonal Signaling in the Gut

Côté

Zadeh-Tahmasebi

Rasmussen

et al. 2014

Journal of Biological Chemistry

View full text Add to dashboard Cite

show abstract

“…This effect is achieved through a weight lossindependent mechanism. This phenomenon is supported by the absence of significant weight loss but also by other factors, such as the lack of improvement in insulin resistance [14] and the moderate increase in serum C-peptide that occurs a few months after the operation [13]. However, the positive impact that RYGB has on T2D has been repeatedly demonstrated in clinical studies over the last 20 years.…”

Section: Mechanismsmentioning

confidence: 93%

“…The GJB has been clinically tested, mostly in small studies of low-BMI patients, with a relatively short follow-up. The majority of these studies have shown significant improvement in patient glycemic status [12][13][14]. This effect is achieved through a weight lossindependent mechanism.…”

Section: Mechanismsmentioning

confidence: 99%

A novel approach for diabetes: recent evidence on endoluminal liners

Romero-Talamás

Brethauer

2013

Diabetes Management

View full text Add to dashboard Cite

The obesity-diabetes pandemic is a devastating contemporary public health issue that for decades has been steadily on the rise. As knowledge and experience have been progressively acquired, numerous strategies and techniques for its management have arisen. Currently, only surgical treatment offers significant and durable results in terms of weight loss, and remission or improvement of comorbidities. With the objective of offering less invasive alternatives, several endoscopic devices have been introduced. Only the endoscopic duodenal-jejunal liner effectively simulates the bypass component of certain bariatric procedures. Initially designed for weight loss, this endoluminal artifact later proved to also provide a powerful metabolic effect. Although it is still in an investigational phase, the device is a promising tool for the treatment of obesity.Two modern pandemics, obesity and diabetes, are considered the most significant causes of morbidity and mortality in the 21st century.There is a strong association between obesity and diabetes and they need to be managed in tandem for many patients.Bariatric surgery has proven to be the only durable effective therapy for patients with severe obesity and related comorbidities.Procedures that bypass the foregut and deliver the nutrients directly to the distal bowel have a favorable metabolic effect on glucose homeostasis.Several novel endoscopic therapies are available for the treatment of morbid obesity. Only the endoscopic duodenal-jejunal liner has been designed to replicate the effect of the surgical duodenal-jejunal bypass.Although promising, the endoscopic duodenal-jejunal liner is still an investigational device.

show abstract

“…Gender, duration of T2DM, previous use of insulin, and preoperative HOMA-IR and C-peptide levels were not significant predictive factors for success or nonsuccess. The only factor that signifi cantly predicted postoperative positive outcomes was a waist circumference reduction of at least 7 % compared with the baseline within the fi rst 6 months after surgery [ 13 ].…”

Section: "Classic" Duodenal-jejunal Bypassmentioning

confidence: 99%