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Published in: Diabetologia 7/2015

Open Access 01-07-2015 | Short Communication

Type 2 diabetes mellitus and microvascular complications 1 year after Roux-en-Y gastric bypass: a case–control study

Authors: Alexander D. Miras, Ling Ling Chuah, Nofal Khalil, Alessia Nicotra, Amoolya Vusirikala, Najah Baqai, Christopher Graham, Saranya Ravindra, Gerassimos Lascaratos, Nick Oliver, Carel W. le Roux

Published in: Diabetologia | Issue 7/2015

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Abstract

Aims/hypothesis

We aimed to examine the effects of bariatric surgery on microvascular complications in patients with type 2 diabetes using objective measures.

Methods

Prospective case–control study of 70 obese surgical patients with type 2 diabetes undergoing gastric bypass surgery matched for age, sex and duration of diabetes to 25 medical patients treated using international guidelines. Microvascular complications were assessed before and 12–18 months after intervention using urine albumin creatinine ratio (ACR) measurements, two-field digital retinal images and peripheral nerve conduction studies (in the surgical group only).

Results

Urine ACR decreased significantly in the surgical group but increased in the medical group. There were no significant differences between the surgical and medical groups in the changes in retinopathy. There were no changes in the nerve conduction variables in the surgical group.

Conclusions/interpretation

In the short term, bariatric surgery may be superior to medical care in the treatment of diabetic nephropathy, but not retinopathy or neuropathy.
Literature
1.
go back to reference Sjostrom L, Peltonen M, Jacobson P et al (2014) Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 311:2297–2304PubMedCrossRef Sjostrom L, Peltonen M, Jacobson P et al (2014) Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA 311:2297–2304PubMedCrossRef
2.
go back to reference Olbers T, Lonroth H, Fagevik-Olsen M, Lundell L (2003) Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Obes Surg 13:364–370PubMedCrossRef Olbers T, Lonroth H, Fagevik-Olsen M, Lundell L (2003) Laparoscopic gastric bypass: development of technique, respiratory function, and long-term outcome. Obes Surg 13:364–370PubMedCrossRef
3.
go back to reference Nathan DM, Buse JB, Davidson MB et al (2009) Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 52:17–30PubMedCrossRef Nathan DM, Buse JB, Davidson MB et al (2009) Medical management of hyperglycaemia in type 2 diabetes mellitus: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement from the American Diabetes Association and the European Association for the Study of Diabetes. Diabetologia 52:17–30PubMedCrossRef
4.
go back to reference Wilkinson CP, Ferris FL 3rd, Klein RE et al (2003) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 110:1677–1682PubMedCrossRef Wilkinson CP, Ferris FL 3rd, Klein RE et al (2003) Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology 110:1677–1682PubMedCrossRef
5.
go back to reference Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen KF, Sandvik L, Aagenaes O (1985) Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study. BMJ (Clin Res Ed) 290:811–815CrossRef Dahl-Jorgensen K, Brinchmann-Hansen O, Hanssen KF, Sandvik L, Aagenaes O (1985) Rapid tightening of blood glucose control leads to transient deterioration of retinopathy in insulin dependent diabetes mellitus: the Oslo study. BMJ (Clin Res Ed) 290:811–815CrossRef
6.
go back to reference Miras AD, Chuah LL, Lascaratos G et al (2012) Bariatric surgery does not exacerbate and may be beneficial for the microvascular complications of type 2 diabetes. Diabetes Care 35, e81PubMedCentralPubMedCrossRef Miras AD, Chuah LL, Lascaratos G et al (2012) Bariatric surgery does not exacerbate and may be beneficial for the microvascular complications of type 2 diabetes. Diabetes Care 35, e81PubMedCentralPubMedCrossRef
7.
go back to reference Iaconelli A, Panunzi S, de Gaetano A et al (2011) Effects of bilio-pancreatic diversion on diabetic complications: a 10-year follow-up. Diabetes Care 34:561–567PubMedCentralPubMedCrossRef Iaconelli A, Panunzi S, de Gaetano A et al (2011) Effects of bilio-pancreatic diversion on diabetic complications: a 10-year follow-up. Diabetes Care 34:561–567PubMedCentralPubMedCrossRef
8.
go back to reference Vantyghem MC, Quintin D, Caiazzo R et al (2014) Improvement of electrophysiological neuropathy after islet transplantation for type 1 diabetes: a 5-year prospective study. Diabetes Care 37:e141–e142PubMedCrossRef Vantyghem MC, Quintin D, Caiazzo R et al (2014) Improvement of electrophysiological neuropathy after islet transplantation for type 1 diabetes: a 5-year prospective study. Diabetes Care 37:e141–e142PubMedCrossRef
Metadata
Title
Type 2 diabetes mellitus and microvascular complications 1 year after Roux-en-Y gastric bypass: a case–control study
Authors
Alexander D. Miras
Ling Ling Chuah
Nofal Khalil
Alessia Nicotra
Amoolya Vusirikala
Najah Baqai
Christopher Graham
Saranya Ravindra
Gerassimos Lascaratos
Nick Oliver
Carel W. le Roux
Publication date
01-07-2015
Publisher
Springer Berlin Heidelberg
Published in
Diabetologia / Issue 7/2015
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-015-3595-7

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