Gastric bypass surgery reveals independency of obesity and diabetes melitus type 2
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Gastric bypass surgery reveals independency of obesity and diabetes melitus type 2. / Fenger, Mogens; Hansen, Dorte Lindqvist; Worm, Dorte; Hvolris, Lisbeth Edvardsen; Kristiansen, Viggo B; Carlsson, Elin Rebecka; Madsbad, Sten.
I: BMC Endocrine Disorders, Bind 16, 59, 09.11.2016, s. 1-10.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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T1 - Gastric bypass surgery reveals independency of obesity and diabetes melitus type 2
AU - Fenger, Mogens
AU - Hansen, Dorte Lindqvist
AU - Worm, Dorte
AU - Hvolris, Lisbeth Edvardsen
AU - Kristiansen, Viggo B
AU - Carlsson, Elin Rebecka
AU - Madsbad, Sten
PY - 2016/11/9
Y1 - 2016/11/9
N2 - BACKGROUND: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but the observation may suggest that the fate obesity and diabetes is only partly linked after surgery.METHODS: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects with and without diabetes were evaluated. Evaluation was performed on three groups: 1) subjects that were non-diabetic before and after surgery; 2) subjects that were diabetics before surgery but non-diabetics after surgery; and 3) subjects that were diabetics before surgery and remained diabetics after surgery. The diabetic state was established at HbA1c above 48 mmol/mol.RESULTS: The trajectories differ significantly between groups and any sub-populations of groups, the latter identified by the distance between individual trajectories using a k-means procedure. The results suggest that different domains in the enormous genetic network governing basic metabolism are perturbed in obesity and diabetes, and in fact some of the patients are affected by two distinct diseases: obesity and diabetes mellitus type 2.CONCLUSION: Although RYGB "normalized" many glycaemic parameters in some of the diabetic subjects apparently converting to a non-diabetics state, other diabetic subjects stay diabetic in the context of the new gut anatomy after surgery. Thus, the obesity part of the glycaemic derangement may have been ameliorated, but some defects of the diabetic state had not.
AB - BACKGROUND: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes in people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before any weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but the observation may suggest that the fate obesity and diabetes is only partly linked after surgery.METHODS: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects with and without diabetes were evaluated. Evaluation was performed on three groups: 1) subjects that were non-diabetic before and after surgery; 2) subjects that were diabetics before surgery but non-diabetics after surgery; and 3) subjects that were diabetics before surgery and remained diabetics after surgery. The diabetic state was established at HbA1c above 48 mmol/mol.RESULTS: The trajectories differ significantly between groups and any sub-populations of groups, the latter identified by the distance between individual trajectories using a k-means procedure. The results suggest that different domains in the enormous genetic network governing basic metabolism are perturbed in obesity and diabetes, and in fact some of the patients are affected by two distinct diseases: obesity and diabetes mellitus type 2.CONCLUSION: Although RYGB "normalized" many glycaemic parameters in some of the diabetic subjects apparently converting to a non-diabetics state, other diabetic subjects stay diabetic in the context of the new gut anatomy after surgery. Thus, the obesity part of the glycaemic derangement may have been ameliorated, but some defects of the diabetic state had not.
KW - Blood Glucose
KW - Body Mass Index
KW - C-Reactive Protein
KW - Diabetes Mellitus, Type 2
KW - Female
KW - Gastric Bypass
KW - Hemoglobin A, Glycosylated
KW - Humans
KW - Insulin
KW - Male
KW - Obesity
KW - Risk Factors
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1186/s12902-016-0140-8
DO - 10.1186/s12902-016-0140-8
M3 - Journal article
C2 - 27829412
VL - 16
SP - 1
EP - 10
JO - BMC Endocrine Disorders
JF - BMC Endocrine Disorders
SN - 1472-6823
M1 - 59
ER -
ID: 174179334