Ileal interposition coupled with duodenal diverted sleeve gastrectomy versus standard medical treatment in type 2 diabetes mellitus obese patients: long-term results of a case–control study

Foschi, Diego; Sorrentino, Luca; Tubazio, Igor; Vecchio, Consuelo; Vago, Tarcisio; Bevilacqua, Maurizio; Rizzi, Andrea; Corsi, Fabio

doi:10.1007/s00464-018-6443-2

Cited by 7 publications

(3 citation statements)

References 51 publications

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“…In comparison with best medical treatment, BMS is able to induce a remission of clinically overt diabetes [110], together with the improvement of cardiovascular performance (obstructive sleep apnea, left ventricular hypertrophy, hypertension, markers of early atherosclerosis), kidney function, liver function, endothelial dysfunction, and inflammation [111,112].…”

Section: Available Means To Prevent the Progression Of Prediabetes To...mentioning

confidence: 99%

Prevention of Diabetes and Cardiovascular Disease in Obesity

Sala

Pontiroli

2020

IJMS

109

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Obesity is one of the major risk factors for the development of both impaired glucose tolerance (IGT, or prediabetes) and type 2 diabetes (T2D), and its prevalence worldwide drives toward an increased rate of cardiovascular morbidity and mortality. Given the estimations of the World Health Organization (WHO) and the recommendation of the Diabetes Prevention Program (DPP), where IGT and diabetes are considered as risk factors for the development of cardiovascular complications and obesity, the development of diabetes should be treated because of its potential reversibility. In this view, several interventions such as diet, lifestyle changes, and pharmacological treatment are effective, including bariatric metabolic surgery (BMS), which is the most incisive way to efficiently lower body weight. In this review, we sought to summarize some of the major aspects linked to diabetes prevention in overweight/obesity, focusing on the use of surgery; we also attempted to elucidate molecular pathways involved in a variety of obesity-induced processes able to favor the progression of chronic diseases, such as diabetes and its complications.

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Section: Available Means To Prevent the Progression Of Prediabetes To...mentioning

confidence: 99%

Prevention of Diabetes and Cardiovascular Disease in Obesity

Sala

Pontiroli

2020

IJMS

109

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“…Folschi et al, comparing SGDII to medical treatment in T2D obese patients (BMI > 30), found, after ve years, remission in 68% of the cases. [29] Considering the duration of diabetes, more than four years, and the BMI, the rate of T2D remission after SGDII is higher than after RYGB (29%) with a ve year follow up [30] Parikh et al, on a systematic review with meta-analysis of diabetes remission among patients with a BMI < 35 kg/m 2 , found an overall rate of diabetes remission at 12 months of 54.7% of the cases, the highest one after ileal interposition (80.5% − 95% CI, 59.4-92.3%) [31] The average BMI preoperatively was 33.43 kg/m 2 , and postoperatively it was 26.17 kg/m 2 , demonstrating that surgery does not promote excessive weight loss in non-obese patients.…”

Section: Discussionmentioning

confidence: 99%

Five year follow up after surgical treatment of type 2 diabetes with laparoscopic sleeve gastrectomy associated with a duodenal ileal interposition

Tinoco,

NETTO,

BENEDITO

et al. 2023

Preprint

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Introduction: Type 2 diabetes mellitus (T2D) is a chronic disease, primarily caused by a combination of defective insulin secretion and the inability of insulin-sensitive tissues to respond to insulin. Laparoscopic sleeve gastrectomy associated with duodenal ileal interposition (SGDII) has been shown to be a feasible treatment option for patients with T2D, as it provides improvement and control of glycemia, dyslipidemia and arterial hypertension. The aim of this study was to evaluate the mid and long-term results of SGDII for the treatment of diabetic patients, considering diabetic remission, weight loss and postoperative complications. Materials and Methods: Retrospective study with 96 patients with T2D submitted to SGDII, between 2010 and 2016. The glycated hemoglobin (HbA1c) value < 6.5%, without the use of hypoglycemic agents, was considered as remission of T2D. Results: The five year follow up demonstrated that 80% of patients had T2D remission at one year, 74.5% at three years and 61.8% at five years. The average duration of the disease was nine years and the mean glycated hemoglobin before surgery was 8.95%. Sixty-one patients (62.8%) were male, and 36 patients (37.2%) were female. The average age was 50.9 years. Median BMI was 33.43 kg/m2. The incidence of major postoperative complications in the first 30 days was 2.1%, with no mortality. Dyslipidemia control was sustained, after five years, in 62% of the patients. Conclusion: SGDII resulted in good glycemic control at 5-years follow-up and represents a valid alternative for the treatment of T2D.

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“…Studies of IT have been performed in rats for over 30 years (20). In recent years, IT has also been used in patients, with satisfactory outcomes (21)(22)(23). Unlike RYGB and VSG, IT does not involve gastrectomy; i.e., it is a "pure" intestinal operation which is suitable for GI research.…”

Section: Discussionmentioning

confidence: 99%

Roles of Gastric Emptying and Gastrointestinal Transit Following Ileal Interposition in Alleviating Diabetes in Goto-Kakizaki Rats

et al. 2022

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ObjectiveThis study aimed to determine the change of gastrointestinal (GI) emptying time after ileal interposition (IT) and elucidate the role of altered GI peristalsis in diabetic control.Materials and MethodsTwelve male Goto-Kakizaki rats were randomly divided into IT and sham groups. Body weight and food intake were recorded. Oral glucose tolerance test (OGTT), insulin tolerance test (ITT), plasma glucagon-like peptide-1 (GLP-1), and gastric emptying were measured at baseline and 4 and 8 weeks after operation. At 9 weeks postoperatively, the rats in the IT group were given atropine which can suppress the emptying of stomach and upper intestine, while sham rats were given metoclopramide (to expedite gastric emptying) for 1 week. At week 10 postoperatively, OGTT and GLP-1 were detected. The intestinal transit was tested at postoperative 12 weeks.ResultsNo differences were found between groups at baseline. After operation, the IT rats had lower body weight than sham rats. At 4 and 8 weeks postoperatively, the IT group showed better OGTT and ITT, with significantly elevated GLP-1 relative to sham. After administration of the GI motility drugs, however, the effect of diabetic control for the two groups became similar. The GI transit after IT was significantly slower than sham at all tested time points.ConclusionsAlthough IT inhibits the GI transit time, the earlier interaction between undigested nutrients and interpositioned ileum promotes gut hormone secretion and thus reduces body weight and alleviates hyperglycemia. A decrease of GI transit of IT rats exacerbates the antidiabetic effects.

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Ileal interposition coupled with duodenal diverted sleeve gastrectomy versus standard medical treatment in type 2 diabetes mellitus obese patients: long-term results of a case–control study

Abstract: II-DD-SG is an effective surgical procedure, able to induce complete and prolonged remission of T2DM in obese patients as opposed to medical treatment.

Cited by 7 publications

References 51 publications

Prevention of Diabetes and Cardiovascular Disease in Obesity

Prevention of Diabetes and Cardiovascular Disease in Obesity

Five year follow up after surgical treatment of type 2 diabetes with laparoscopic sleeve gastrectomy associated with a duodenal ileal interposition

Roles of Gastric Emptying and Gastrointestinal Transit Following Ileal Interposition in Alleviating Diabetes in Goto-Kakizaki Rats

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