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    • All
    • 3D Medical Videos
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    Recent Advances in Surgery-Updates 30

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    Sleeve Gastrectomy  Optimal Surgical Treatment for Type 2 Diabetes: or Gastric Bypass

    Sleeve Gastrectomy Optimal Surgical Treatment for Type 2 Diabetes: or Gastric Bypass

    A Trainer Reveals the Best Exercises For a Stronger, Toned Butt

    Unused Dental Surgery Prescriptions May Help Fuel Opioid Epidemic

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    Drinking This Kind of Tea Could Help Shed Those Last Few Pounds

    This Easy Cardio Swap Will Help You Train for A Half Marathon

    5 Must-Follow Rules If You Want to Get Strong

    Load Up on Shrooms With These Healthy Recipes

    6 Ways to Burn More Calories Doing Bodyweight Exercises

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    What Your Legs Could Be Telling You About Your Heart Health

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    What is Salicylic acid and why should I use it on my skin?

    Drinking coffee could protect against some types of cancer

    10 Things Every Woman Should Know About Yeast Infections

  • Fitness

    A Trainer Reveals the Best Exercises For a Stronger, Toned Butt

    A Trainer Answers: What’s the Best Workout For Losing Weight?

    This Easy Cardio Swap Will Help You Train for A Half Marathon

    5 Must-Follow Rules If You Want to Get Strong

    Can This Weight-Loss Pill Really Help You Lose Weight?

    6 Ways to Burn More Calories Doing Bodyweight Exercises

    10 Fat-Burning Moves That Will Help You Lose Weight

  • Nutrition

    How To Lose 10 Pounds Even If You Hate Vegetables

    These Foods to Absolutely Avoid If You Want Clear, Glowing Skin

    Drinking This Kind of Tea Could Help Shed Those Last Few Pounds

    What bleeding gums mean for people with diabetes

    What is Salicylic acid and why should I use it on my skin?

    Drinking coffee could protect against some types of cancer

    Can This Weight-Loss Pill Really Help You Lose Weight?

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    A Trainer Reveals the Best Exercises For a Stronger, Toned Butt

    Unused Dental Surgery Prescriptions May Help Fuel Opioid Epidemic

    Researchers Examine Impact of Soda on Children’s Dental Health

    Dental Care for Kids: When Should Your Child Start Going to the Dentist?

    How To Lose 10 Pounds Even If You Hate Vegetables

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Sleeve Gastrectomy Optimal Surgical Treatment for Type 2 Diabetes: or Gastric Bypass

by medicare nepal
June 15, 2022
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Clinical evidence from randomized, controlled trials

Although the literature is filled with retrospective comparisons of diabetes outcomes for patients who underwent sleeve gastrectomy or gastric bypass, several high-quality, well-conducted, prospective, randomized studies have been performed. We summarize these studies here.

In a multicenter, randomized, controlled trial, Wallenius and colleagues [9] randomized 49 patients with severe obesity and type 2 diabetes to sleeve gastrectomy or gastric bypass and followed up them for 2 years. Remission

The physiology of obesity as it relates to diabetes

To understand how sleeve gastrectomy or gastric bypass can ameliorate diabetes in patients with obesity, one must first understand some of the physiologic changes associated with obesity and glucose homeostasis. In patients with obesity, adipose tissue releases increased amounts of nonesterified fatty acids, glycerol, hormones, proinflammatory cytokines, and other factors that result in insulin resistance [15]. When insulin resistance is accompanied by dysfunction of pancreatic beta cells,

Mechanisms of diabetes resolution after sleeve gastrectomy or gastric bypass

Fig. 1 shows how both sleeve gastrectomy and gastric bypass affect glucose homeostasis to result in a reduction of fasting blood glucose and A1c. Both sleeve gastrectomy and gastric bypass cause increased release of ghrelin, peptide YY, incretins, and bile acids—all of which contribute to diabetes improvement via more insulin secretion or less insulin resistance. The only pathway unique to gastric bypass is duodenal exclusion. We discuss each pathway below:

Summary

Available clinical evidence from prospective, randomized trials has shown that sleeve gastrectomy and gastric bypass produce similar improvements in type 2 diabetes after up to 5 years of follow-up. Mechanistically, many of the pathways for diabetes improvement that were originally described for gastric bypass have now been shown to occur after sleeve gastrectomy. As such, based on current evidence, we recommend clinicians and patients choose between bypass or sleeve based on factors other than 

Disclosure

The authors have nothing to disclose.

references : Optimal Surgical Treatment for Type 2 Diabetes: Sleeve Gastrectomy or Gastric Bypass? – ScienceDirect

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