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Metabolic function may improve with duodenal-jejunal bypass surgery
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Duodenal-jejunal bypass surgery with minimal gastric resection improved metabolic function and induced moderate weight loss in adults with overweight or obesity and type 2 diabetes, according to recent study findings published in Obesity.
Samuel Klein, MD, of the Center for Human Nutrition and the Atkins Center of Excellence in Obesity Medicine at Washington University School of Medicine, St. Louis, and colleagues evaluated 17 adults with overweight or obesity and type 2 diabetes who underwent standard medical care (n = 7) or duodenal-jejunal bypass surgery with minimal gastric resection (DJBm; n = 10) to determine the effect of each on regulated glucose homeostasis.
Samuel Klein
All participants were assessed for body weight, use of diabetes medications and plasma lipids and completed the 5-hour modified oral glucose tolerance test at 1, 6 and 12 months.
Body weight of participants who underwent DJBm decreased by 7.9% at 1 month, 9.6% at 6 months and 10.2% at 12 months, whereas the standard care group stayed within 1% of their initial body weight for 12 months.
Fasting plasma glucose concentrations and plasma HbA1c decreased in both groups throughout the study period with no significant differences between them.
Compared with baseline, at 1, 6 and 12 months, the DJBm group had lower plasma glucose concentrations 2 hours after the OGTT (P = .039) and increased insulin sensitivity (P = .013), early insulin response to a glucose load (increased insulinogenic index; P = .022) and overall glycemic control, whereas no changes were found among the standard care group.
“In summary, we found that DJBm surgery improved metabolic function and glycemic control in overweight and obese subjects with [type 2 diabetes],” the researchers wrote. “However, this procedure also caused a 10% weight loss, so it is not possible to separate the effect of [upper gastrointestinal] tract bypass from weight loss itself on the therapeutic effects of surgery. DJBm did not induce diabetes remission in any subject, which suggests that another factor(s), possibly the nearly threefold greater weight loss observed after [Roux-en-Y gastric bypass] than DJBm, is an important contributor to glycemic control after [Roux-en-Y gastric bypass] surgery.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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