Analysis of predictors of Type II Diabetes remission and weight regain after surgery for morbidly obese patients

• Grant number: 16/16145-6
• Support Opportunities: Regular Research Grants
• Start date: September 01, 2017
• End date: August 31, 2019
• Field of knowledge: Health Sciences - Medicine - Surgery
• Principal Investigator: Marco Aurélio Santo
• Grantee: Marco Aurélio Santo
• Host Institution: Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Flavio Masato Kawamoto ; Priscila Caproni ; Roberto de Cleva

Abstract

Type 2 Diabetes mellitus (T2DM) is a multiple etiology syndrome, resulting from insulin deficiency and / or inability of it to properly perform its functions, determining a chronic hyperglycemia with consequences in multiple viscera and functions commonly associated with endothelial dysfunction and micro and macrovascular changes, with increased risk of atherosclerotic vascular disease.First treatment for T2DM is medicated with oral hypoglycemic agents. However, almost half of the patients will require insulin use to achieve adequate glycemic control due to progressive failure of insulin secretion by ² cells in the pancreas. The definition of a successful surgical treatment is based on weight loss and improvement or resolution of preoperative comorbidities, assuming satisfactory loss maintaining at least 50% overweight. (17, 18) The weight regained after bariatric surgery is consequent to multiple factors, since anatomical (such as the production of gastric pouch large volume or the occurrence of leakage between the gastric pouch and excluded stomach), entero hormones (such as attenuation of inhibition and secretion of hormones involved in controlling satiety as ghrelin and GLP1) and behavioral (as compulsive phenomena, especially focused on the massive intake of carbohydrates). It is estimated that up to 30% of patients undergoing Roux-y gastric bypass, the follow-up period of five years, may regain weight in the range considered as failure, and the worst results in the group of super-obese patients (BMI> 50kg / m²). The objective of this study is evaluate factors related to clinical and laboratory evolution of T2DM and the weight regained in patients with morbid obesity undergoing Roux-Y gastroplasty. It will be a study divided in two phases, with data collected retrospectively and other prospective phase. Patients undergoing gastroplasty diagnosed with diabetes and / or weight regained will be selected and invited to follow-up and collection of clinical data, conducting measurements and laboratory curves relating to diabetes and entero-hormone secretion. The work will be developed in Bariatric and Metabolic Surgery Unit and Discipline of the Digestive Surgery of the Hospital das Clinicas, FMUSP. (AU)

Scientific publications

(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)

DE CLEVA, ROBERTO; KAWAMOTO, FLAVIO; BORGES, GEORGIA; CAPRONI, PRISCILA; FLORES CASSENOTE, ALEX JONES; SANTO, MARCO AURELIO. C-peptide level as predictor of type 2 diabetes remission and body composition changes in non-diabetic and diabetic patients after Roux-en-Y gastric bypass. Clinics, v. 76, 2021. (16/16145-6)