Metabolic Surgery In Obese Patients Research Articles

IDF23-0192 The role of metabolic surgery in obese patients with type 2 diabetes

IDF23-0192 The role of metabolic surgery in obese patients with type 2 diabetes

Bibliometric analysis of metabolic surgery for type 2 diabetes: current status and future prospects

Metabolic surgery has become a powerful treatment for obese type 2 diabetes (T2DM). Experts have been devoting to the research of metabolic surgery in the treatment of T2DM. The debate continues, and there is no comprehensive statistical and intuitive analysis for it. To explore the current research status, the latest hotspots and the changing trend in this field, we conducted a bibliometric analysis. This paper made a bibliometric analysis based on the data source from Science Core Collection Network (WoSCC). Vosviewer v.1.6.10 software is used to construct a knowledge map. From 2011 to 2020, 1424 peer-reviewed papers on metabolic surgery for T2DM were retrieved. The United States contributed the most publications and gained global impact with the most citations. Obesity Surgery was the most prolific journal in this field. Prof. Schauer Philip R., Prof. Buchwald H. and Prof. Sjostrom L. were the most renowned experts in this aspect. The top cited references discussed the status of metabolic surgery for the treatment of T2DM worldwide and the importance of regular evaluation. The extracted keywords mainly formed three clusters: (1) research on the selection of different metabolic surgery methods; (2) possible mechanisms; (3) improvement of T2DM complications by metabolic surgery. Our study makes a comprehensive and objective analysis of metabolic surgery in obese patients with T2DM, providing valuable information for further clinical application and related scientific research. Researchers can quickly locate research hotspots in a large number of relevant literature.

Outcomes of metabolic surgery in obese patients with type 2 diabetes with respect to impact on beta cell function, insulin sensitivity and diabetes remission - A study from south India

Background and aimsMetabolic surgery is gaining popularity as a procedure for the treatment of morbid obesity among patients with type 2 diabetes (T2DM). The aim of the study was to evaluate the effects of metabolic surgery on beta cell function, insulin sensitivity and glycemic status in obese Asian Indian patients. MethodsThis is a prospective study of 26 patients with T2DM who underwent metabolic surgery. Complete diabetes remission was defined as FPG<100 mg/dl and HbA1c < 6%, without antidiabetic medications one-year post surgery. Anthropometry, HOMA-IR (insulin resistance), HOMA-insulin sensitivity, beta cell function and antidiabetic drug usage were measured at baseline, 6 months and 12 months post-surgery. ResultsThe overall duration of diabetes was 10.3 ± 5.4 years. At one year, 7 (27%) of 26 T2DM patients, achieved diabetes remission while the other 19 had improvement in diabetes status. ROC curves showed that those who had diabetes duration <8.5 years achieved remission. There was a significant decrease in HOMA-IR [3.7 ± 1.8 vs 1.4 ± 0.9 vs1.2 ± 0.6, p < 0.001] and improvement in HOMA-Insulin sensitivity [34 ± 17 vs 93 ± 50 vs 112 ± 62, p < 0.001] from baseline to 6 and 12 months post-surgery respectively. There was a significant (p < 0.001) reduction in the usage of anti-diabetes medications post-surgery. The limitations of this study are small sample size and limited follow up period of 1 year. ConclusionsAmong T2DM patients, metabolic surgery resulted in significant improvement in beta cell function and insulin sensitivity along with reduction in anti-diabetes medication. Diabetes remission was mainly seen in those who had duration of diabetes <8.5 years.

Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass

Background: Gastroesophageal reflux disease (GERD) is one of the most important obesity-related comorbidity, with prevalence >50% in obese population. Roux-en-Y gastric bypass (RYGB) is considered the gold standard for metabolic surgery in obese patients with GERD, but in a subgroup of patients this pathological GERD may be not really controlled after this technique. Aims of this article are to discuss surgical and endoscopic options to manage refractory GERD after RYGB. Materials and Methods: We realized a literature review using the PubMed database and searching articles published before December 2019 about GERD after RYGB. Results: We found six studies, four case reports, and two retrospective studies about surgical and endoscopic options to treat this subgroup of patients. Discussion: Pharmacological therapy and life style optimization are the first line of treatment. For resistant GERD, new surgical and endoscopic strategies are proposed in the past years to manage this subgroup of patients related to anatomic limitation of RYGB. Conclusion: More studies are needed to compare surgical and endoscopic solutions. The choice of treatment depends on local resources and skills, and if necessary refer the patient to a specialist center.

Depression,anxiety and their effects on quality of life before metabolic surgery in obese patients

Objective To investigate the status of depression/anxiety in obese patients seeking metabolic surgery and analyze the effects of depression/anxiety on different aspects of quality of life. Methods Convenient sampling was used and 117 metabolic surgery were recruited from the Department of Bariatric and Metabolic Surgery in the First Affiliated Hospital of Nanjing Medical University from March to July,2017. Patient Health Questionnaire(PHQ-9),Generalized Anxiety Disorder 7-item scale(GAD-7), 12 item Short-Form Health Survey (SF-12) and the general information and disease characteristics questionnaire were used to collect data. Results Nearly 25.6%(30/117) of the patients suffered from moderate, moderately severe and severe depression symptoms and the median and interquartile range of PHQ-9 was 6 and 7 points. 16.2% (19/117) of the patients had moderate and severe anxiety symptoms and the median and interquartile range of GAD-7 was 3 and 6 points. Multiple linear regression analysis showed that scores in the physical component of the SF-12 were associated with the body mass index, the presence of comorbidities and depression,which could explain 20.0% of the total variance; the symptoms of depression and anxiety were negatively related to the mental component summary of SF-12, which could explain 49.6% of the total variance. Conclusions The present findings suggests that there is a high occurrence of depression and anxiety in metabolic surgery patients, which severely impair the patients′ quality of life. As for the obese patients seeking metabolic surgery for treatment, routine screening of depression and anxiety incorporating the diagnosis of the problems are warranted. Then intervention based on the assessment can be exerted to maximize the benefit of patients undergoing the surgery in the long term. Key words: Anxiety; Depression; Quality of life; Metabolic surgery