التفاصيل البيبلوغرافية
| العنوان: |
Gastric bypass in Type 2 diabetes with BMI < 30: weight and weight loss have a major influence on outcomes. |
| المؤلفون: |
Dixon, J. B.1,2, Hur, K.‐Y.3, Lee, W.‐J.4, Kim, M.‐J.3, Chong, K.5, Chen, S.‐C.4, Straznicky, N. E.1, Zimmet, P.1 |
| المصدر: |
Diabetic Medicine. Apr2013, Vol. 30 Issue 4, pe127-e134. 8p. 3 Charts, 2 Graphs. |
| مصطلحات موضوعية: |
*TYPE 2 diabetes treatment, *GASTRIC bypass, *ACADEMIC medical centers, *BODY weight, *C-peptide, *DIABETES, *GLYCOSYLATED hemoglobin, *EVALUATION of medical care, *METABOLIC regulation, *TYPE 2 diabetes, *SCIENTIFIC observation, *PREOPERATIVE care, *OPERATIVE surgery, *WEIGHT loss, *DATA analysis, *BODY mass index, *ACQUISITION of data, *RECEIVER operating characteristic curves, *DATA analysis software |
| مستخلص: |
Aim To assess factors influencing glycaemic control following gastric bypass surgery in patients with Type 2 diabetes and BMI< 30 kg/m2. Methods Prospective longitudinal study of 103 patients with inadequate glycaemic control who underwent gastric bypass surgery at Soonchunhyang University, Seoul, Korea ( n = 66) and Min-Sheng General Hospital, Taipei, Taiwan ( n = 37). Procedures were performed August 2009 to January 2011. Key outcome measures were excellent glycaemic control of Type 2 diabetes defined as HbA1c < 42 mmol/mol (≤6%); inadequate response defined as HbA1c > 53 mmol/mol (> 7%). Analysis was conducted using binary logistic regression, and cut-points obtained from receiver operator characteristics. Results Excellent glycaemic control was achieved in 31 (30%) at 1 year. Diabetes duration of < 7 years and BMI > 27 kg/m2 provided independent predictors and useful cut-points. Likelihood of excellent glycaemic control for an individual could be estimated using loge (Odds) = -6.7 + (0.26 × BMI) + (-1.2 × diabetes duration). Baseline BMI of < 27 kg/m2 and baseline C-peptide of < 2.0ng/ml, best predicted a poor glycaemic response. In those with favourable baseline characteristics percentage weight loss (% WL) had a dominant influence on glycaemic outcomes. Baseline C-peptide (> 2.4 ng/ml) and subsequent percentage weight loss (> 16%) were associated with excellent glycaemic control. Higher BMI was associated with greater percentage weight loss. Conclusion In patients with Type 2 diabetes and BMI < 30 kg/m2, glycaemic response to gastric bypass is predicted by higher baseline BMI, shorter disease duration and higher fasting C-peptide. Post-surgery weight loss has a dominant effect. Baseline BMI and weight loss have a major influence on outcomes. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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