448 research outputs found
Assessing the Actual Clinical Effectiveness of Metabolic/Bariatric Surgery for the Type 2 Diabetes Therapy
No full text
From bariatric to metabolic surgery: Looking for a "disease modifier" surgery for type 2 diabetes.
No full textIn this review the recent evolution of the comprehension of clinical and metabolic consequences of bariatric surgery is depicted. At the beginning bariatric surgery aim was a significant and durable weight loss. Later on, it became evident that bariatric surgery was associated with metabolic changes, activated by unknown pathways, partially or totally independent of weight loss. Paradigm of this "metabolic" surgery is its effects on type 2 diabetes mellitus (T2DM). In morbid obese subjects it was observed a dramatic metabolic response leading to decrease blood glucose, till diabetes remission, before the achievement of clinically significant weight loss, opening the avenue to search for putative anti-diabetic "intestinal" factors. Both proximal duodenal (still unknown) and distal (GLP1) signals have been suggested as hormonal effectors of surgery on blood glucose decrease. Despite these findings T2DM remission was never considered a primary indication for bariatric surgery but only a secondary one. Recently T2DM remission in obese subjects with body mass index (BMI) greater than 35 has become a primary aim for surgery. This change supports the idea that "metabolic surgery" definition could more appropriate than bariatric, allowing to explore the possibility that metabolic surgery could represent a "disease modifier" for T2DM. Therefore, several patients have undergone surgery with a primary aim of a definitive cure of T2DM and today this surgery can be proposed as an alternative therapy. How much surgery can be considered truly metabolic is still unknown. To be truly "metabolic" it should be demonstrated that surgery could cause T2DM remission not only in subjects with BMI > 35 but also with BMI < 35 or even < 30. Available evidence on this topic is discussed in this mini-review
Cys 786 and Cys 776 in the posttranslational processing of the insulin and IGF-I receptors
No full textCLINICAL STUDY: Acute plasma glucose increase, but not early insulin response, regulates plasma ghrelin.
No full textA ser for Cys mutation in the extracellular portion of insulin receptor beta subunit impairs the insulin-insulin receptor complex internalization in CHO cells.
No full textAdipokine Pattern After Bariatric Surgery: Beyond the Weight Loss.
No full textBesides the role in energy storing and body health isolating, adipose tissue
produces proteins, the so-called adipokines, with pro-inflammatory or
anti-inflammatory actions that contribute to metabolic control and to appetite
and energy expenditure regulation. The marked adipose tissue loss following
bariatric surgery corresponds to a rearrangement of serum adipokine pattern, with
increase of anti-inflammatory and decrease of pro-inflammatory agents. This might
play a relevant role in the postoperative improvement of metabolic conditions.
However, after surgically induced weight loss, other investigations failed to
evidence significant modifications of serum concentration of some adipokines.
This review speculates that the composition of adipose tissue lost could
influence postoperative changes in some adipokine concentration and that an
adequate adipokine pattern plays a pivotal role for the long-term metabolic
outcome
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