Document Detail


Prospective controlled study of effect of laparoscopic sleeve gastrectomy on small bowel transit time and gastric emptying half-time in morbidly obese patients with type 2 diabetes mellitus.
MedLine Citation:
PMID:  20189465     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Published data on sleeve gastrectomy (SG) have indicated better remission of type 2 diabetes mellitus (T2DM) and improvement in satiety compared with other restrictive procedures. Mechanisms in addition to rapid, extensive weight loss are responsible for the restoration of the euglycemic state. To prospectively evaluate the role of laparoscopic SG on gastric emptying half-time and small bowel transit time (SBTT) and effect of these on weight loss, satiety, and improvement in T2DM. METHODS: A total of 67 subjects were studied. Of these 67 subjects, 24 were lean controls (body mass index 22.2 +/- 2.84 kg/m(2)), 20 were severely and morbidly obese patients with T2DM who had not undergone SG (body mass index 37.73 +/- 5.35 kg/m(2)), and 23 were severely and morbidly obese patients with T2DM after SG (body mass index 40.71 +/- 6.59 kg/m(2)). All 67 patients were evaluated for gastric emptying half-time and SBTT using scintigraphic imaging. Imaging was performed every 15 minutes up to the ileocecal region. The Three-Factor Eating Questionnaire was administered simultaneously. Fasting blood sugar, postprandial blood sugar, and glycated hemoglobin were assessed. Nonparametric analysis of variance and the Mann-Whitney U test were applied. RESULTS: The mean SBTT was significantly lower (P <.05) in the post-SG group (199 +/- 65.7 minutes) than in the non-SG group (281.5 +/- 46.2 minutes) or control group (298.1 +/- 9.2 minutes). The gastric emptying half-time values were also significantly shorter (P <.05) in the post-SG (52.8 +/- 13.5 minutes) than in the non-SG (73.7 +/- 29.0 minutes) and control (72.8 +/- 29.6 minutes) groups. The glycated hemoglobin, fasting blood sugar, and postprandial sugar were all significantly lower after SG. The Three-Factor Eating Questionnaire findings revealed significantly earlier satiety (29.0 +/- 7.2) for the post-SG patients (P <.05) compared with the non-SG (45.8 +/- 9.0) and control (37.9 +/- 6.2) subjects. CONCLUSION: A decreased gastric emptying half-time and SBTT after SG can possibly contribute to better glucose homeostasis in patients with T2DM.
Authors:
Shashank Shah; Poonam Shah; Jayashree Todkar; Michel Gagner; S Sonar; S Solav
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article     Date:  2009-12-22
Journal Detail:
Title:  Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery     Volume:  6     ISSN:  1878-7533     ISO Abbreviation:  Surg Obes Relat Dis     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-04-02     Completed Date:  2010-07-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101233161     Medline TA:  Surg Obes Relat Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Ruby Hall Clinic, Pune, India. drshashankshah@ediffmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose
Diabetes Mellitus, Type 2 / complications,  physiopathology*,  surgery
Female
Gastrectomy
Gastric Emptying*
Gastrointestinal Transit*
Humans
Intestine, Small / physiology*
Laparoscopy
Male
Middle Aged
Obesity, Morbid / complications,  physiopathology,  surgery*
Prospective Studies
Questionnaires
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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