TY - JOUR

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 -