Metabolic Effects of Bariatric Surgery in PatientsWithModerate Obesity and Type 2 Diabetes Analysis of a randomized control trial comparing surgery with intensive medical treatment

نویسندگان

  • SANGEETA R. KASHYAP
  • RICHARD M. WATANABE
  • STACY BRETHAUER
  • JOHN P. KIRWAN
چکیده

RESULTSdGlycemic control improved in all three groups at 24months (N5 54), with amean HbA1c of 6.76 1.2% for gastric bypass, 7.16 0.8% for sleeve gastrectomy, and 8.46 2.3% for IMT (P , 0.05 for each surgical group versus IMT). Reduction in body fat was similar for both surgery groups, with greater absolute reduction in truncal fat in gastric bypass versus sleeve gastrectomy (216 vs.210%; P5 0.04). Insulin sensitivity increased significantly from baseline in gastric bypass (2.7-fold; P5 0.004) and did not change in sleeve gastrectomy or IMT. b-cell function (oral disposition index) increased 5.8-fold in gastric bypass from baseline, was markedly greater than IMT (P5 0.001), and was not different between sleeve gastrectomy versus IMT (P5 0.30). At 24 months, b-cell function inversely correlated with truncal fat and prandial free fatty acid levels.

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تاریخ انتشار 2013