Michał Wysocki1,2, Magdalena Szopa3, Tomasz Stefura4, Alicja Dudek4, Grzegorz Torbicz4, Natalia Gajewska4, Michał Pędziwiatr1,2, Piotr Małczak1,2, Magdalena Pisarska1,2, Andrzej Budzyński1,2, Piotr Major5,6. 1. 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. 2. Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland. 3. Department of Metabolic Diseases, Jagiellonian University Medical College, Kopernika 15 St., 31-501, Kraków, Poland. 4. Students' Scientific Group at 2nd Department of Surgery, Jagiellonian University Medical College, Kraków, Poland. 5. 2nd Department of General Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. piotr.major@uj.edu.pl. 6. Centre for Research, Training and Innovation in Surgery (CERTAIN Surgery), Krakow, Poland. piotr.major@uj.edu.pl.
Abstract
BACKGROUND: Few investigations have been conducted that compared blood glucose in patients with diabetes mellitus (DM2) and morbid obesity who had undergone laparoscopic sleeve gastrectomy (LSG) or gastric bypass (LRYGB). We aimed to compare the effects of these procedures using continuous glucose monitoring (CGM). METHODS: We prospectively studied patients that had qualified for LSG or LRYGB. The inclusion criteria were DM2 of ≤ 5 years, for which patients were taking oral anti-diabetic drugs, or no glucose metabolism disorder; and morbid obesity. CGM was performed between admission and the 10th postoperative day. RESULTS: We studied 16 patients with DM2 and 16 without. Eighteen patients underwent LSG and 14 underwent LRYGB. The median hemoglobin A1c was 5.5% (5.4-5.9%) in DM2 patients, which did not differ from control (p = 0.460). Preoperative mean daily glucose concentration was similar between DM2 and control patients (p = 0.622). For patients with DM2, LRYGB was associated with more frequent low glucose status, and these episodes lasted longer than in DM2 patients that underwent LSG (p = 0.035 and 0.049, respectively). DM2 patients that underwent LRYGB demonstrated lower glucose concentrations from third postoperative day than those that underwent LSG. Patients without DM2 did not demonstrate differences in daily mean glucose concentrations, or in incidence nor duration of hypoglycemia throughout the observation period. CONCLUSION: A significantly larger reduction in interstitial glucose concentration is present from third day in patients with DM2 who undergo LRYGB vs. LSG, accompanied by a lower incidence and shorter duration of low glucose episodes.
BACKGROUND: Few investigations have been conducted that compared blood glucose in patients with diabetes mellitus (DM2) and morbid obesity who had undergone laparoscopic sleeve gastrectomy (LSG) or gastric bypass (LRYGB). We aimed to compare the effects of these procedures using continuous glucose monitoring (CGM). METHODS: We prospectively studied patients that had qualified for LSG or LRYGB. The inclusion criteria were DM2 of ≤ 5 years, for which patients were taking oral anti-diabetic drugs, or no glucose metabolism disorder; and morbid obesity. CGM was performed between admission and the 10th postoperative day. RESULTS: We studied 16 patients with DM2 and 16 without. Eighteen patients underwent LSG and 14 underwent LRYGB. The median hemoglobin A1c was 5.5% (5.4-5.9%) in DM2 patients, which did not differ from control (p = 0.460). Preoperative mean daily glucose concentration was similar between DM2 and control patients (p = 0.622). For patients with DM2, LRYGB was associated with more frequent low glucose status, and these episodes lasted longer than in DM2 patients that underwent LSG (p = 0.035 and 0.049, respectively). DM2 patients that underwent LRYGB demonstrated lower glucose concentrations from third postoperative day than those that underwent LSG. Patients without DM2 did not demonstrate differences in daily mean glucose concentrations, or in incidence nor duration of hypoglycemia throughout the observation period. CONCLUSION: A significantly larger reduction in interstitial glucose concentration is present from third day in patients with DM2 who undergo LRYGB vs. LSG, accompanied by a lower incidence and shorter duration of low glucose episodes.
Authors: Michał Wysocki; Maciej Walędziak; Hady Razak Hady; Mikołaj Czerniawski; Monika Proczko-Stepaniak; Michał Szymański; Natalia Dowgiałło-Wnukiewicz; Piotr Kozera; Jacek Szeliga; Michał Orłowski; Michał Pędziwiatr; Magdalena Szopa; Andrzej Budzyński; Piotr Major Journal: Obes Surg Date: 2019-09 Impact factor: 4.129
Authors: Elizabeth Hegedus; Sarah-Jeanne Salvy; Choo Phei Wee; Monica Naguib; Jennifer K Raymond; D Steven Fox; Alaina P Vidmar Journal: Obes Res Clin Pract Date: 2021-09-02 Impact factor: 5.214