PMID- 27138599
OWN - NLM
STAT- MEDLINE
DCOM- 20171102
LR  - 20190318
IS  - 1708-0428 (Electronic)
IS  - 0960-8923 (Linking)
VI  - 26
IP  - 12
DP  - 2016 Dec
TI  - Compared to Sleeve Gastrectomy, Duodenal-Jejunal Bypass with Sleeve Gastrectomy 
      Gives Better Glycemic Control in T2DM Patients, with a Lower beta-Cell Response and 
      Similar Appetite Sensations: Mixed-Meal Study.
PG  - 2862-2872
AB  - BACKGROUND: Functional studies of how duodenal-jejunal exclusion (DJE) brings a 
      superior glycemic control when added to sleeve gastrectomy in duodenal-jejunal 
      bypass with sleeve gastrectomy (DJB-SG) patients, are lacking. To study this, we 
      compared the appetite sensations and the beta-cell response following a standard 
      mixed meal in patients with DJB-SG, versus those with sleeve gastrectomy (SG) 
      alone. METHODS: Twenty one patients who underwent DJB-SG and 25 with SG, who 
      participated in mixed-meal tests (MMTT) preoperatively and at 1 year, with 
      complete data were included and compared. Blood glucose, C-peptide, and insulin 
      levels were estimated, along with the visual analogue scale (VAS) scoring of the 
      six appetite sensations, as a part of the MMTT. RESULTS: At 1 year following 
      surgery, compared to SG group, DJB-SG group had greater complete remission rates 
      (HbA1C <6.0 %) of 62 versus 32 % (p < 0.05), with similar total body weight loss 
      (25.7 vs. 22 %). There were significantly lower post-prandial blood glucose and 
      lower C-peptide levels during the MMTT in the patients with DJB-SG compared to SG 
      group. There were no significant differences in the appetite sensations (mean 
      VAS) scores between the groups. CONCLUSION: The addition of DJE component to SG, 
      as in DJB-SG, was associated with higher diabetes remission rates, lower glycemic 
      fluctuations, and lower C-peptide levels. This may point to a beta-cell preserving 
      glucose control which could result in longer remission of type 2 diabetes 
      mellitus (T2DM). This effect also may be unrelated to food intake as there were 
      no significant differences in the appetite sensations.
FAU - Zachariah, Pulimuttil James
AU  - Zachariah PJ
AD  - Department of Surgery and Diabetic Surgery Study Center, Min-Sheng General 
      Hospital, No. 168, Chin-Kuo Road, Touyuan City, Taiwan.
AD  - Department of General, Laparoscopic and Bariatric Surgery, Zulekha Hospital 
      Dubai, Dubai, United Arab Emirates.
FAU - Chen, Chih-Yen
AU  - Chen CY
AD  - Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, 
      Taiwan.
AD  - Division of Gastroenterology and Hepatology, Department of Medicine, Taipei 
      Veterans General Hospital, Taipei, Taiwan.
FAU - Lee, Wei-Jei
AU  - Lee WJ
AD  - Department of Surgery and Diabetic Surgery Study Center, Min-Sheng General 
      Hospital, No. 168, Chin-Kuo Road, Touyuan City, Taiwan. 
      wjlee_obessurg_tw@yahoo.com.tw.
FAU - Chen, Shu-Chu
AU  - Chen SC
AD  - Department of Surgery and Diabetic Surgery Study Center, Min-Sheng General 
      Hospital, No. 168, Chin-Kuo Road, Touyuan City, Taiwan.
FAU - Ser, Kong-Han
AU  - Ser KH
AD  - Department of Surgery and Diabetic Surgery Study Center, Min-Sheng General 
      Hospital, No. 168, Chin-Kuo Road, Touyuan City, Taiwan.
FAU - Chen, Jung-Chien
AU  - Chen JC
AD  - Department of Surgery and Diabetic Surgery Study Center, Min-Sheng General 
      Hospital, No. 168, Chin-Kuo Road, Touyuan City, Taiwan.
FAU - Lee, Yi-Chih
AU  - Lee YC
AD  - Department of International Business, Chien Hsin University of Science and 
      Technology, Taoyuan City, Taiwan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Obes Surg
JT  - Obesity surgery
JID - 9106714
RN  - 0 (Blood Glucose)
RN  - 0 (Insulin)
SB  - IM
MH  - Adult
MH  - Appetite/*physiology
MH  - Blood Glucose/*metabolism
MH  - Diabetes Mellitus, Type 2/blood/*surgery
MH  - Duodenum/surgery
MH  - Female
MH  - Gastrectomy/adverse effects/*methods
MH  - Gastric Bypass/adverse effects/*methods
MH  - Humans
MH  - Insulin/blood/metabolism
MH  - Insulin Secretion
MH  - Insulin-Secreting Cells/*metabolism
MH  - Jejunum/surgery
MH  - Male
MH  - Meals
MH  - Middle Aged
MH  - Postprandial Period
MH  - Remission Induction
MH  - Retrospective Studies
MH  - Satiety Response/physiology
MH  - Sensation
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Duodenal-jejunal bypass
OT  - *Metabolic surgery
OT  - *Mixed-meal tolerance test
OT  - *Sleeve gastrectomy
OT  - *beta-cell response
EDAT- 2016/05/04 06:00
MHDA- 2017/11/03 06:00
CRDT- 2016/05/04 06:00
PHST- 2016/05/04 06:00 [pubmed]
PHST- 2017/11/03 06:00 [medline]
PHST- 2016/05/04 06:00 [entrez]
AID - 10.1007/s11695-016-2205-1 [pii]
AID - 10.1007/s11695-016-2205-1 [doi]
PST - ppublish
SO  - Obes Surg. 2016 Dec;26(12):2862-2872. doi: 10.1007/s11695-016-2205-1.