Pros and cons of Roux en-Y gastric bypass surgery in obese patients with type 2 diabetes.

Pros and cons of Roux en-Y gastric bypass surgery in obese patients with type 2 diabetes. Expert Rev Endocrinol Metab. 2019 Jun 19;:1-15 Authors: Justinussen T, Madsbad S, Holst JJ, Bojsen-Møller KN Abstract Introduction: The worldwide prevalence of obesity and type 2 diabetes (T2D) constitutes an epidemic that is a threat to public health. Bariatric surgery, including Roux en-Y gastric bypass (RYGB), is currently the most effective treatment to induce long-term weight loss and remission of co-morbid conditions. Surgery, however, comes with an added risk of complications, highlighting the need to understand the comparative effectiveness and risks of surgical versus conventional approaches to the treatment of obesity and T2D. Areas covered: Positive and negative outcomes of RYGB surgery in patients with T2D are assessed, with a primary focus on RYGB surgery versus standard non-surgical treatment of obese patients with T2D in randomized clinical trials or high-quality observational cohorts. Searches were conducted in the PubMed database up to 11 April 2019 for relevant studies. Expert opinion: High-level evidence reveals that RYGB ameliorates the clinical manifestations of T2D to a significantly higher degree than medical therapy. Postoperative incidence of beneficial effects and complications, however, differ across subgroups of patients with different preoperative characteristics. Key knowledge gaps, particularly on long-term complications, microva...
Source: Expert Review of Endocrinology and Metabolism - Category: Endocrinology Tags: Expert Rev Endocrinol Metab Source Type: research

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In a society where physical activity is limited and food supply is abundant, metabolic diseases are becoming a serious epidemic. Metabolic syndrome (MetS) represents a cluster of metabolically related symptoms such as obesity, hypertension, dyslipidemia, and carbohydrate intolerance, and significantly increases type 2 diabetes mellitus risk. Insulin resistance and hyperinsulinemia are consistent characteristics of MetS, but which of these features is the initiating insult is still widely debated. Regardless, both of these conditions trigger adverse responses from the pancreatic β cell, which is responsible for produci...
Source: Journal of Clinical Investigation - Category: Biomedical Science Authors: Source Type: research
The obesity and type-2 diabetes epidemic is escalating and represents one of the costliest biomedical challenges confronting modern society. Moreover, the increasing consumption of high fat food is often correlated with an increase in body mass index. In people predisposed to be obese or already obese, the impaired ability of the brain to monitor and respond to alterations in fatty acid (FA) metabolism is increasingly recognized as playing a role in the pathophysiological development of these disorders. The brain senses and regulates metabolism using highly specialized nutrient-sensing neurons located mainly in the hypotha...
Source: Frontiers in Physiology - Category: Physiology Source Type: research
Last February, Weight Watchers set off a firestorm when it announced it would offer its weight-loss program, for free, to teens ages 13 to 17. It angered many parents, as well as eating-disorders experts who felt it could give rise to obsessive and unhealthy behaviors in adolescents. WW—as the company rebranded itself last September—refused to shrink from the criticism, says CEO Mindy Grossman. “It actually strengthened our resolve and made us offensive.” Now, WW is doubling down: On Aug. 13, the company rolled out Kurbo by WW, a free nutrition and weight-loss app for kids as young as 8, and up to 1...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized Weight loss Source Type: news
Obesity is a disease that currently affects our population in epidemic proportions, and which has a profound effect on health and quality of life. As a physician dedicated to the prevention and treatment of the medical complications of excess weight, I frequently see patients whose efforts at restricting calories and increasing physical activity are not resulting in sustained weight loss. When that’s the case, particularly if the excess weight is causing health issues, we can consider adding other treatment tools, which include weight loss medications, or weight loss surgeries. And while these options have increased ...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Diet and Weight Loss Health Healthy Eating Source Type: blogs
CONCLUSIONS: More studies should be conducted to prove the most effective nutritional intervention in GDM. Regarding the potential effectiveness of MI, further evidences in multicenter , randomized controlled trials are needed to draw firm conclusions. PMID: 31333107 [PubMed - as supplied by publisher]
Source: Current Pharmaceutical Design - Category: Drugs & Pharmacology Authors: Tags: Curr Pharm Des Source Type: research
Conclusion: The presence of the PNPLA3 G allele is associated with a risk of NAFLD. Our study shows that subjects with variant PNPLA3 are not only at increased risk for the development and progression of NAFLD, but also have increased insulin resistance. PMID: 31304703 [PubMed - in process]
Source: Journal of the Association of Physicians of India - Category: General Medicine Tags: J Assoc Physicians India Source Type: research
Publication date: Available online 10 July 2019Source: The Lancet Diabetes &EndocrinologyAuthor(s): Ian J Neeland, Robert Ross, Jean-Pierre Després, Yuji Matsuzawa, Shizuya Yamashita, Iris Shai, Jaap Seidell, Paolo Magni, Raul D Santos, Benoit Arsenault, Ada Cuevas, Frank B Hu, Bruce Griffin, Alberto Zambon, Philip Barter, Jean-Charles Fruchart, Robert H Eckel, International Atherosclerosis Society, International Chair on Cardiometabolic Risk Working Group on Visceral ObesitySummaryFindings from epidemiological studies over the past 30 years have shown that visceral adipose tissue, accurately measured by CT or M...
Source: The Lancet Diabetes and Endocrinology - Category: Endocrinology Source Type: research
Source: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy - Category: Endocrinology Tags: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy Source Type: research
, Santos MM Abstract Obesity, a risk factor for the development of type-2 diabetes, hypertension, cardiovascular disease, hepatic steatosis and some cancers, has been ranked in the top 10 health risk in the world by the World Health Organization. Despite the growing body of literature evidencing an association between the obesity epidemic and specific chemical exposure across a wide range of animal taxa, very few studies assessed the effects of chemical mixtures and environmental samples on lipid homeostasis. Additionally, the mode of action of several chemicals reported to alter lipid homeostasis is still poorly ...
Source: Ecotoxicology and Environmental Safety - Category: Environmental Health Authors: Tags: Ecotoxicol Environ Saf Source Type: research
CONCLUSION: The growing burden of NAFLD as a public health problem in Turkey is underscored by its marked histological severity in terms of NASH and fibrosis. Well-conducted clinical trials will be essential for slowing down the NASH progression. PMID: 31258138 [PubMed - as supplied by publisher]
Source: The Turkish Journal of Gastroenterology - Category: Gastroenterology Authors: Tags: Turk J Gastroenterol Source Type: research
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