术前降血糖药物与减肥手术后2型糖尿病的关系

IF 0.4 Q4 ENDOCRINOLOGY & METABOLISM
H. Raja, Saarah Ebrahim, R. Mamidanna, K. Patel, A. Askari, C. Arhi, A. Munasinghe, F. Rashid, O. Al-Taan, P. Jambulingam, D. Whitelaw, V. Jain, A. Zalin, T. Rehman, MD Tanveer Asil
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引用次数: 0

摘要

引言:减肥手术是治疗2型糖尿病(T2DM)病态肥胖患者的有效方法。本研究调查了在常规临床环境中,糖尿病和抗糖尿病治疗的持续时间是否与手术后的血糖控制有关。方法:对2017年4月至2018年3月期间为2型糖尿病患者进行的连续减肥手术的前瞻性数据库进行队列分析。结果:共有105名2型糖尿病病人接受了减肥手术(89例Roux-en-Y胃旁路术和16例袖状胃切除术)。中位随访时间为19个月([四分位间距]IQR 13-24个月)。手术当天的中位体重和体重指数(BMI)分别为125 kg(IQR 103.9-138.7)和42.4 kg/m2(IQR 39-46.8)。在随访中,68名患者(64.8%)的糖尿病病情得到缓解。与服用单一降糖药物的患者相比,术前服用一种以上降糖药物的病人病情缓解的可能性较小(比值比[OR]0.13,95%CI 0.04-0.44,p=0.001)。术前使用胰岛素治疗(OR 0.09,95%CI 0.03-0.31,p=减肥手术后12个月。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Association between preoperative glucose- lowering medication agents and the status of type 2 diabetes mellitus after bariatric surgery
Introduction: Bariatric surgery is an effective treatment for type 2 diabetes mellitus (T2DM) in patients with morbid obesity. This study investigates whether duration of diabetes and anti-diabetes therapy are associated with glycaemic control after surgery in a routine clinical setting. Method: A cohort analysis of a prospectively maintained database was carried out for consecutive bariatric operations performed between April 2017 and March 2018 for patients with T2DM. Results: A total 105 patients with T2DM underwent bariatric surgery (89 Roux-en-Y gastric bypass and 16 sleeve gastrectomy). Median follow-up was 19 months ([interquartile range] IQR 13-24 months). Median weight and body mass index (BMI) on the day of surgery were 125 kg (IQR 103.9- 138.7) and 42.4 kg/m2 (IQR 39-46.8), respectively. At follow- up, 68 patients (64.8%) had achieved remission of diabetes. Patients who were pre-operatively on more than one glucose-lowering medication were less likely to go into remission (odds ratio [OR] 0.13, 95% CI 0.04-0.44, p=0.001) compared to those that were on a single glucose-lowering medication agent. Pre-operative use of insulin therapy (OR 0.09, 95% CI 0.03-0.31, p=<0.001) and SGLT2 inhibitors (OR 0.23, 95% CI 0.05-0.92, p=0.038) were significant negative predictors of remission. Type of operation (p=0.34), pre-operative BMI (p=0.99), and % total weight loss (TWL) (p=0.83) did not predict remission from T2DM after surgery. Conclusions: Most patients who are medicated for T2DM can stop their glucose-lowering medication after bariatric surgery. Patients who are on multiple glucose-lowering medication agents or those dependent on insulin or SGLT2 inhibitors before bariatric surgery are less likely to undergo complete remission >12 months after bariatric surgery.
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来源期刊
British Journal of Diabetes
British Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
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16.70%
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15
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