Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

Tsilingiris, Dimitrios; Koliaki, Chrysi; Kokkinos, Alexander

doi:10.3390/ijerph16173171

Cited by 54 publications

(41 citation statements)

References 128 publications

(156 reference statements)

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“…However, gender and baseline BMI in non-Asian ethnicities could not predict diabetes remission. The results of our study are comparable with several other studies suggesting that gender and BMI had no effect on diabetes remission [6].…”

Section: Discussionsupporting

confidence: 92%

Metabolic Efficacy and Diabetes Remission Predictors Following ‘Sleeve Gastrectomy with Loop Duodenojejunal Bypass’ Surgery

Vennapusa

Panchangam²,

Kesara

et al. 2020

J Metab Bariatr Surg

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Purpose Laparoscopic sleeve gastrectomy with loop duodenojejunal bypass (SLDJB) is a novel metabolic surgery that is a modification of the single anastomosis duodenoileal bypass with sleeve. Compared to conventional surgeries, SLDJB is highly effective in inducing diabetes remission. This study analyzed the metabolic efficacy of SLDJB. Materials and Methods Seventy-eight patients with obesity and diabetes who underwent SLDJB between May 2013 and October 2017 were retrospectively analyzed to investigate the efficacy of their surgery and diabetes remission predictors. Complete diabetes remission was defined as an HbA1 c level <6% with cessation of insulin and oral hypoglycemic agents. Results Complete diabetes remission occurred in 80.52% and 76.71% of patients at 1- and 3-year follow-ups, respectively. There was no significant difference in the rates of complete diabetes remission between the groups based on gender, preoperative body mass index (BMI), diabetes duration or preoperative insulin use. There was a significantly higher rate of complete remission in patients <50 years of age at the 1-year follow-up. Additionally, the rate of complete remission was significantly less when preoperative glycemic control was poor. Preoperative HbA1 c levels negatively predicted complete remission, but was significant only at the 3-year follow-up. Conclusion SLDJB is highly effective in treating obesity with type 2 diabetes, and preoperative glycemic control was found to predict complete remission. Patients under 50 years of age had a better short-term response rate; however, the surgery was effective regardless of gender, preoperative BMI, duration of diabetes or preoperative insulin use.

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Section: Discussionsupporting

confidence: 92%

Metabolic Efficacy and Diabetes Remission Predictors Following ‘Sleeve Gastrectomy with Loop Duodenojejunal Bypass’ Surgery

Vennapusa

Panchangam²,

Kesara

et al. 2020

J Metab Bariatr Surg

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show abstract

“…Recommendations indicate bariatric surgery as the preferred treatment for T2D in class III obese (body mass index (BMI) ≥40) subjects, with consideration of surgery for class II obese individuals (BMI 35-39.9) with inadequate control of hyperglycemia. T2D remission rates might vary depending on the surgical procedure, studied population, and definition of T2D remission [177].…”

Section: Bariatric Surgerymentioning

confidence: 99%

Anti-Inflammatory Strategies Targeting Metaflammation in Type 2 Diabetes

Kuryłowicz

Koźniewski

2020

Molecules

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One of the concepts explaining the coincidence of obesity and type 2 diabetes (T2D) is the metaflammation theory. This chronic, low-grade inflammatory state originating from metabolic cells in response to excess nutrients, contributes to the development of T2D by increasing insulin resistance in peripheral tissues (mainly in the liver, muscles, and adipose tissue) and by targeting pancreatic islets and in this way impairing insulin secretion. Given the role of this not related to infection inflammation in the development of both: insulin resistance and insulitis, anti-inflammatory strategies could be helpful not only to control T2D symptoms but also to treat its causes. This review presents current concepts regarding the role of metaflammation in the development of T2D in obese individuals as well as data concerning possible application of different anti-inflammatory strategies (including lifestyle interventions, the extra-glycemic potential of classical antidiabetic compounds, nonsteroidal anti-inflammatory drugs, immunomodulatory therapies, and bariatric surgery) in the management of T2D.

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“…This study was the first documentation of bariatric surgery as a potential "cure'' for T2DM. 7 The researchers also observed that younger patients and those with a shorter duration of T2DM were more likely to go into remission postoperatively. 8 More evidence supporting the role of bariatric surgery in the treatment of T2DM emerged in the early 2000s.…”

mentioning

confidence: 95%

Preoperative Bariatric Surgery Predictors of Type 2 Diabetes Remission

Fultang

Chinaka

Rankin

et al. 2021

Journal of Obesity & Metabolic Syndrome

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Obesity represents a significant proportion of the global public health burden, with the World Health Organization (WHO) estimating more than 600 million people are affected worldwide. Unfortunately, the epidemic of obesity is linked to the increased prevalence of associated metabolic diseases such as type 2 diabetes mellitus (T2DM). Bariatric surgery as an intervention has been shown to provide sustainable weight loss, and also leads to superior short- and long-term metabolic benefits including T2DM remission. Despite this added advantage conferred by bariatric surgery, emerging evidence has shown that not all patients with T2DM achieve remission postoperatively. As such, to improve patient selection and optimize preoperative counselling, research has focused on the preoperative predictors of T2DM remission following bariatric surgery. Herein, we provide a critical review of the current literature addressing preoperative predictors of T2DM remission and highlight the current gaps in the literature. The review comprised a multistage advanced electronic search of the Ovid/Medline, Embase, and Cochrane online libraries to identify available studies published over the last decade.

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Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

Cited by 54 publications

References 128 publications

Metabolic Efficacy and Diabetes Remission Predictors Following ‘Sleeve Gastrectomy with Loop Duodenojejunal Bypass’ Surgery

Metabolic Efficacy and Diabetes Remission Predictors Following ‘Sleeve Gastrectomy with Loop Duodenojejunal Bypass’ Surgery

Anti-Inflammatory Strategies Targeting Metaflammation in Type 2 Diabetes

Preoperative Bariatric Surgery Predictors of Type 2 Diabetes Remission

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