المؤلفون: Qi, Qi Yang Damien, Playfair, Julie, Brown, Wendy A., Burton, Paul, O'Brien, Paul E., Wentworth, John M.

المصدر: Diabetes, Obesity & Metabolism; Jun2023, Vol. 25 Issue 6, p1464-1472, 9p

مصطلحات موضوعية: TYPE 2 diabetes, WEIGHT loss, GASTRIC banding, OVERWEIGHT persons, MORBID obesity, DISEASE remission

مستخلص: Aim: Randomized trials reporting 5‐year outcomes have shown bariatric surgery to induce diabetes remission and improve cardiovascular risk. However, the longer‐term effects of surgery are uncertain, with only one randomized trial reporting 10‐year diabetes outcomes in people with obesity. We aimed to compare 10‐year diabetes outcomes of people who are overweight but not obese, randomly assigned to receive either multidisciplinary diabetes care, or multidisciplinary diabetes care combined with gastric band (GB) surgery. Methods: Between 2009 and 2011, 51 adults were randomized. After 5 years, they were discharged to receive community care and reassessed after 10 years. The primary outcome was diabetes remission, defined as glycated haemoglobin (HbA1c) <6.5% (48 mmol/mol) without glucose‐lowering medication. Results: Forty‐one participants (20 medical and 21 GB) completed the 10‐year assessment. The median (Q1, Q3) weight loss in the GB group was 9.8 (6.7, 16.3)% at 10 years compared with 5.6 (3.4, 7.6)% in the medical group (median difference 4.2%; p =.008). Diabetes remission occurred in five GB participants and no medical participants (relative risk 0.76, 95% CI: 0.55‐0.93, p =.048). GB participants used fewer glucose‐lowering medications at 10 years but HbA1c, fasting glucose, calculated cardiovascular risk, quality‐of‐life and incident diabetes complications did not differ significantly between the groups. Conclusion: When compared with medical care, GB surgery achieved greater weight loss and modestly increased the likelihood of diabetes remission. However, it did not improve HbA1c, cardiovascular risk or quality of life. [ABSTRACT FROM AUTHOR]

: Copyright of Diabetes, Obesity & Metabolism is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: O'Brien, Paul E., DeWitt, Dawn E., Laurie, Cheryl E., Brennan, Leah, Wentworth, John M., Anderson, Margaret, O'Dea, Kerin, Dean, Felicia, Smith, Andrew, Dalton, David P.

مصطلحات موضوعية: type 2 diabetes, obesity, bariatric surgery, gastric banding, LAGB, indigenous Aboriginal, remission of diabetes, weight loss

الوصف: Background/Objectives: Diabetes and obesity are common and serious health challenges for indigenous people worldwide. The feasibility of achieving substantial weight loss, leading to remission of diabetes, was evaluated in a regional indigenous Australian community. Subjects/Methods: A prospective cohort study of 30 obese indigenous adults from the Rumbalara Aboriginal Co-operative in Central Victoria was performed. Inclusion criteria included aboriginality, BMI > 30 kg/m2 and diabetes diagnosed within the last 10 years. Weight loss was achieved using laparoscopic adjustable gastric banding (LAGB). Participants were treated in their community and followed for 2 years. Outcomes were compared with those of non-indigenous Australians from an earlier randomized controlled trial (RCT) using a similar protocol. Results: 30 participants (26 females, mean age 44.6 years; mean BMI 44.3) had LAGB at the regional hospital. Twenty-six participants completed diabetes assessment at 2 years follow-up. They showed diabetes remission (fasting blood glucose < 7.0 mmol/L and haemoglobin A1c (HbA1c) < 6.2 % while off all therapy except metformin) in 20 of the 26 and a mean weight loss (SD) of 26.0 (14) kilograms. Based on intention-to-treat, remission rate was 66 %. Quality of life improved. There was one early event and 12 late adverse events. The outcomes for weight loss and diabetes remission were not different from the LAGB group of the RCT. Conclusions: For obese indigenous people with diabetes, a regionalized model of care centred on the LAGB is an effective approach to a serious health problem. The model proved feasible and acceptable to the indigenous people. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN 12609000319279).

العلاقة: https://acuresearchbank.acu.edu.au/item/8q845/the-effect-of-weight-loss-on-indigenous-australians-with-diabetes-a-study-of-feasibility-acceptability-and-effectiveness-of-laparoscopic-adjustable-gastric-bandingTest; https://doi.org/10.1007/s11695-015-1733-4Test; O'Brien, Paul E., DeWitt, Dawn E., Laurie, Cheryl E., Brennan, Leah, Wentworth, John M., Anderson, Margaret, O'Dea, Kerin, Dean, Felicia, Smith, Andrew and Dalton, David P. (2016). The effect of weight loss on Indigenous Australians with diabetes: A study of feasibility, acceptability and effectiveness of laparoscopic adjustable gastric banding. Obesity Surgery. 26(1), pp. 45 - 53. https://doi.org/10.1007/s11695-015-1733-4Test

الإتاحة: https://doi.org/10.1007/s11695-015-1733-4Test

المؤلفون: Doyle, Lisa, Laurie, Cheryl, O'Brien, Paul E., Ooi, Geraldine J., Burton, Paul R., Brown, Wendy A., Earnest, Arul, Wentworth, John M., Sikaris, Ken, le Roux, Carel W.

المصدر: Obesity Surgery; May2018, Vol. 28 Issue 5, p1351-1362, 12p

مصطلحات موضوعية: BLOOD cholesterol, WEIGHT loss, GASTRIC bypass, DYSLIPIDEMIA, LIPOPROTEINS, TRIGLYCERIDES, INSULIN resistance

مستخلص: Introduction: Dyslipidemia affects up to 75% of morbidly obese individuals and is a key driver of cardiovascular disease. Weight loss is an established strategy to improve metabolic risk, including dyslipidemia. We aimed to determine weight loss goals for resolution of serum lipid abnormalities, by measuring improvements during progressive weight loss in obese individuals.Methods: We performed a prospective cohort study of obese individuals with the metabolic syndrome undergoing adjustable gastric banding. Lipid levels were monitored monthly for 9 months, then three monthly until 24 months.Results: There were 101 participants included, age 47.4 ± 10.9 years with body mass index 42.6 ± 5.9 kg/m². At 24 months, total body weight loss (TBWL) was 18.3 ± 7.9%. This was associated with significant improvements in high-density lipoprotein (HDL) (1.18 vs 1.47, p < 0.001), triglyceride (2.0 vs 1.4, p < 0.001), and total cholesterol to HDL ratio (TC:HDL) (4.6 vs 3.6, p < 0.001). Over this time, progressive and linear improvements in HDL, triglycerides, and TC:HDL were seen with incremental weight loss (observed at 2.5% TBWL intervals). Significant improvements occurred after a threshold weight loss of 7.5-12.5% TBWL was achieved, with odds ratio (OR) 1.48-2.50 for normalization. These odds improved significantly with increasing weight loss (OR 18.2-30.4 with > 25% TBWL). Despite significant weight loss, there was no significant change in low-density lipoprotein (LDL).Conclusion: Significant improvements in triglycerides, HDL, and TC:HDL occur after 7.5-12.5% TBWL, with ongoing benefit after greater weight loss. LDL needs to be addressed independently, as this was not observed to respond to weight loss alone.Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077) [ABSTRACT FROM AUTHOR]

: Copyright of Obesity Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Wentworth, John M., Cheng, Chloe, Laurie, Cheryl, Skinner, Stewart, Burton, Paul R., Brown, Wendy A., O'brien, Paul E.

المصدر: Obesity Surgery; Apr2018, Vol. 28 Issue 4, p982-989, 8p

مصطلحات موضوعية: GASTRIC banding, BARIATRIC surgery, PEOPLE with diabetes, BLOOD pressure, WEIGHT loss

مستخلص: Background: Long-term outcome data are needed to define the role of bariatric surgery in type 2 diabetes (T2D). To address this, we collated diabetes outcomes more than a decade after laparoscopic adjustable gastric band (LAGB) surgery.Method: Clinical and biochemical measures from 113 obese T2D patients who underwent LAGB surgery in 2003 and 2004 were analyzed. Diabetes remission was defined as HbA1c < 6.2% (44 mmol/mol) and fasting glucose < 7.0 mmol/L.Results: Seventy-nine patients had weight data at 10 years and attained a median [Q1, Q3] weight loss of 16 [10, 21] percent. Sixty patients attended a follow-up assessment. Their baseline HbA1c of 7.8 [7.1, 9.3] percentage units (62 [54, 78] mmol/mol) had decreased to 6.6 [6.1, 8.4] (49 [43, 68] mmol/mol) despite no significant change in glucose-lowering therapy. Eleven patients (18%) were in diabetes remission and another 18 had HbA1c ≤ 6.5%. Significant improvements in physical measures of quality of life, blood pressure, and lipid profile were also observed but there was no change in the proportion of patients with albuminuria and a significant decline in estimated glomerular filtration rate. Twelve patients in the follow-up cohort (20%) required anti-reflux medication after surgery and 26 (43%) underwent gastric band revision surgery.Conclusion: Weight loss for over 10 years after LAGB surgery delivers clinically meaningful improvements in HbA1c, blood pressure, lipids, and quality of life at the cost of a high rate of revision surgery and increased use of anti-reflux medication. These findings support the use of bariatric surgery as a long-term treatment for weight loss and wellbeing in patients with T2D.Study Registration: Registered with the Australian Clinical trials registry as ACTRN12615000089538. [ABSTRACT FROM AUTHOR]

: Copyright of Obesity Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Wentworth, John M.^1,2,3 wentworth@wehi.edu.au, Dalziel, Kim M.⁴, O'Brien, Paul E.¹, Burton, Paul¹, Shaba, Frackson⁴, Clarke, Philip M.⁴, Laiteerapong, Neda⁵, Brown, Wendy A.¹, O'Brien, Paul E¹ (AUTHOR)

المصدر: Journal of Diabetes & its Complications. Jul2017, Vol. 31 Issue 7, p1139-1144. 6p.

مصطلحات موضوعية: *TYPE 2 diabetes treatment, *OBESITY, *BARIATRIC surgery, *OBESITY treatment, *COMBINED modality therapy, *TYPE 2 diabetes, *TYPE 2 diabetes complications, *OBESITY complications, *CLINICAL trials, *COST effectiveness, *ECONOMIC aspects of diseases, *MEDICAL care costs, *QUALITY of life, *RESEARCH funding, *SURVEYS, *WEIGHT loss, *COST analysis, *BODY mass index, *STATISTICAL models, *ECONOMICS

مصطلحات جغرافية: AUSTRALIA, UNITED States

مستخلص: Aim: To determine the cost-effectiveness of gastric band surgery in overweight but not obese people who receive standard diabetes care.Method: A microsimulation model (United Kingdom Prospective Diabetes Study outcomes model) was used to project diabetes outcomes and costs from a two-year Australian randomized trial of gastric band (GB) surgery in overweight but not obese people (BMI 25 to 30kg/m2) on to a comparable population of U.S. adults from the National Health and Nutrition Examination Survey (N=254). Estimates of cost-effectiveness were calculated based on the incremental cost-effectiveness ratios (ICERs) for different treatment scenarios. Costs were inflated to 2015 U.S. dollar values and an ICER of less than $50,000 per QALY gained was considered cost-effective.Results: The incremental cost-effectiveness ratio for GB surgery at two years exceeded $90,000 per quality-adjusted life year gained but decreased to $52,000, $29,000 and $22,000 when the health benefits of surgery were assumed to endure for 5, 10 and 15 years respectively. The cost-effectiveness of GB surgery was sensitive to utility gained from weight loss and, to a lesser degree, the costs of GB surgery. However, the cost-effectiveness of GB surgery was affected minimally by improvements in HbA1c, systolic blood pressure and cholesterol.Conclusions: GB surgery for overweight but not obese people with T2D appears to be cost-effective in the U.S. setting if weight loss endures for more than five years. Health utility gained from weight loss is a critical input to cost-effectiveness estimates and therefore should be routinely measured in populations undergoing bariatric surgery. [ABSTRACT FROM AUTHOR]

المؤلفون: Burton, Paul, Wentworth, John, Bhathal, Prithi, Brown, Wendy, Ooi, Geraldine, Doyle, Lisa, O'Brien, Paul, Sikaris, Ken, Cowley, Michael, Roberts, Stuart, Kemp, William, Earnest, Arul

المصدر: Obesity Surgery; Jun2017, Vol. 27 Issue 6, p1533-1542, 10p

مصطلحات موضوعية: FATTY liver, THERAPEUTICS, BARIATRIC surgery, ALANINE aminotransferase, WEIGHT loss, PATIENTS

مستخلص: Objectives: Nonalcoholic fatty liver disease (NAFLD) affects over 80% of obese patients and is fueled by the metabolic syndrome. Weight loss is strongly advocated as a central treatment for NAFLD and has been shown to induce histological improvement. We aimed to define the patterns of improvement in NAFLD with weight loss and determine target weight goals for NAFLD resolution. Methods: A prospective study of 84 morbidly obese patients with NAFLD undergoing bariatric surgery was conducted. Intraoperative liver biopsies were taken. Monthly follow-up, including blood tests and measurements, was performed. We monitored improvements in NAFLD by monthly alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) levels over 1 year. Results: There was rapid improvement in ALT, particularly in the first 6 months following surgery, with statistically significant reduction in ALT at 2 months (35 vs 27 IU/L, p < 0.001). In multivariate analysis, there were significantly increased odds of ALT normalization after a %TBWL of 10-15% (odds ratio 2.49, p = 0.005). The odds of resolution increased with increasing weight loss. Triglyceride levels (odds ratio 0.59, p = 0.021) and baseline NAFLD activity score (odds ratio 0.28, p < 0.001) were also significantly related to ALT normalization. Improvements in ALT occurred prior to metabolic improvement and well before traditional ideal weight goals were reached. Conclusion: Improvements in NAFLD occurred rapidly after bariatric surgery and were closely related to weight loss and metabolic factors. A 10-15% reduction in body weight is an appropriate target to achieve substantial improvement in ALT levels. Trial registration number: Australian Clinical Trials Registry (ACTRN12610000049077). [ABSTRACT FROM AUTHOR]

: Copyright of Obesity Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Wentworth, John, Playfair, Julie, Laurie, Cheryl, Brown, Wendy, Burton, Paul, Shaw, Jonathan, O'Brien, Paul

المصدر: Obesity Surgery; Dec2015, Vol. 25 Issue 12, p2400-2407, 8p

مصطلحات موضوعية: GASTRIC banding, INSULIN, TYPE 2 diabetes, OVERWEIGHT persons, PANCREATIC beta cells, WEIGHT loss

مستخلص: Background: We aimed to determine the effects of laparoscopic adjustable gastric band (LAGB) on beta-cell function in overweight people with type 2 diabetes and to assess the relationship between baseline beta-cell function and glycemic outcomes. Methods: We studied 44 overweight but not obese people with type 2 diabetes who participated in a randomized trial whose primary outcome was the rate of diabetes remission after 2 years of multidisciplinary diabetes care (MDC group) or multidisciplinary care combined with LAGB. Dynamic beta-cell function was assessed by intravenous glucose challenge, and basal beta-cell function (HOMA-B) and insulin sensitivity (HOMA-S) were determined using the homeostatic model. Results: Twelve LAGB participants and two MDC participants were in diabetes remission at 2 years. HOMA-S and the C-peptide response to intravenous glucose increased significantly in LAGB but not in MDC participants. The insulin response to glucose did not change in LAGB participants, whereas their fasting C-peptide/insulin ratio increased. Baseline measures of beta-cell function correlated with diabetes remission but not with reduction in HbA1c following LAGB. Conclusions: In overweight people with diabetes, LAGB improves endogenous beta-cell function after 2 years. Baseline beta-cell function correlated with diabetes remission, but not with HbA1c change following LAGB. [ABSTRACT FROM AUTHOR]

: Copyright of Obesity Surgery is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Wentworth, John

المصدر: Obesity Research & Clinical Practice; Jan2019, Vol. 13 Issue 1, p39-39, 1p

مصطلحات موضوعية: TYPE 2 diabetes prevention, TYPE 2 diabetes risk factors, OBESITY complications, HEALTH status indicators, TYPE 2 diabetes, WEIGHT loss

المؤلفون: Leah Brennan, John M. Wentworth, David P. Dalton, Andrew L. Smith, C Laurie, Kerin O'Dea, Paul E. O'Brien, Felicia Dean, Dawn E. DeWitt, Margaret Louise Anderson

المساهمون: O'Brien, Paul E, DeWitt, Dawn E., Laurie, Cheryl, Brennan, Leah, Wentworth, John M, Anderson, Margaret, O'Dea, Kerin, Dean, Felicia, Smith, Andrew, Dalton, David P.

مصطلحات موضوعية: Male, Pediatrics, obesity, Native Hawaiian or Other Pacific Islander, Endocrinology, Diabetes and Metabolism, Type 2 diabetes, law.invention, Cohort Studies, 0302 clinical medicine, Randomized controlled trial, law, Weight loss, Prospective Studies, 030212 general & internal medicine, Prospective cohort study, Aboriginal, gastric banding, Nutrition and Dietetics, Middle Aged, Obesity, Morbid, Treatment Outcome, Female, type 2 diabetes, medicine.symptom, Cohort study, Adult, medicine.medical_specialty, Gastroplasty, bariatric surgery, 030209 endocrinology & metabolism, 03 medical and health sciences, Diabetes mellitus, medicine, Humans, Aged, Glycated Hemoglobin, business.industry, Australia, Patient Acceptance of Health Care, remission of diabetes, medicine.disease, LAGB, Obesity, Indigenous, Clinical trial, Diabetes Mellitus, Type 2, indigenous Aboriginal, Quality of Life, Physical therapy, Feasibility Studies, Laparoscopy, Surgery, weight loss, business

الوصف: Background/Objectives: Diabetes and obesity are common and serious health challenges for indigenous people worldwide. The feasibility of achieving substantial weight loss, leading to remission of diabetes, was evaluated in a regional indigenous Australian community. Subjects/Methods: A prospective cohort study of 30 obese indigenous adults from the Rumbalara Aboriginal Co-operative in Central Victoria was performed. Inclusion criteria included aboriginality, BMI > 30 kg/m2 and diabetes diagnosed within the last 10 years. Weight loss was achieved using laparoscopic adjustable gastric banding (LAGB). Participants were treated in their community and followed for 2 years. Outcomes were compared with those of non-indigenous Australians from an earlier randomized controlled trial (RCT) using a similar protocol. Results: 30 participants (26 females, mean age 44.6 years; mean BMI 44.3) had LAGB at the regional hospital. Twenty-six participants completed diabetes assessment at 2 years follow-up. They showed diabetes remission (fasting blood glucose < 7.0 mmol/L and haemoglobin A1c (HbA1c) < 6.2 % while off all therapy except metformin) in 20 of the 26 and a mean weight loss (SD) of 26.0 (14) kilograms. Based on intention-to-treat, remission rate was 66 %. Quality of life improved. There was one early event and 12 late adverse events. The outcomes for weight loss and diabetes remission were not different from the LAGB group of the RCT. Conclusions: For obese indigenous people with diabetes, a regionalized model of care centred on the LAGB is an effective approach to a serious health problem. The model proved feasible and acceptable to the indigenous people. Trial Registration: Australian New Zealand Clinical Trials Registry (ACTRN 12609000319279).

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::766914e6b77e8d1e8dcdc5ea06c01f8dTest
https://hdl.handle.net/11541.2/111728Test