Effect of laparoscopic Roux-en-Y gastric bypass surgery on type 2 diabetes mellitus with hypertension: A randomized controlled trial
Abstract
Aims The aim of this study was to evaluate the effect of laparoscopic Roux-en-Y gastric bypass (RYGB) surgery compared with usual care with and without Exenatide therapy in obese people with type 2 diabetes mellitus (T2DM) and hypertension.Methods 108 obese T2DM with hypertension were enrolled and randomly allocated to usual care (group A), usual care plus Exenatide (group B), and RYGB surgery (group C). Demographic characteristics, metabolic parameters and cardiac structure/function along with inflammatory cytokines were measured and compared before and after 12 months.Results At 12 months, diabetes remission had occurred in no patients in groups A and B versus 90% in group C, and there was a significant decrease in requirement of antihypertensive drugs in group C compared with groups A and B (P<0.05). Other parameters (body mass index, hemoglobin A1c, homeostasis model assessment of insulin resistance, lipids), inflammation index (high sensitivity C-reactive protein, tumor necrosis factor-α, high molecular weight adiponectin) and cardiac structure (left ventricular mass index) were significantly improved in groups B and C, but patients in group C had the greatest degree of improvement (P<0.05).Conclusion RYGB surgery improves a number of parameters including cardiovascular function in obese hypertensive people with T2DM. This is likely to be due to, at least in part, an improvement in the abnormal metabolic panel and to reduced inflammation.
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Fifteen RCTs were identified comparing weight loss after bariatric surgery or medical therapy.
“Fifteen RCTs were identified comparing weight loss after bariatric surgery or medical therapy (5 reporting on RYGB, 3 on LAGB and the rest on mixed patient populations undergoing sleeve gastrectomy, BPD/DS, sleeve gastrectomy and/or banding) [21–35].”
Partial or total remission rates in type 2 diabetes as high as 80% to 90% occur following bariatric surgery.
“Partial or total remission rates in type 2 diabetes as high as 80% to 90% have been observed to occur following bariatric surgery [40-45].”
From Bariatric surgery: remission of inflammation, cardiometabolic benefits, and common adverse effects (2020) · cites this paper as [45]
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- Authors
- Liang, Z., Wu, Q., Chen, B., Yu, P., Zhao, H., & Ouyang, X.
- Affiliations
- Army Medical University (CN)
- Yale University (US)
- Corresponding author
- Liang, Ziwen
- Venue
- Diabetes Research and Clinical Practice
- Publisher
- Elsevier BV
- Published
- 2013-07
- Volume
- 101
- Issue
- 1
- Pages
- 50-56
- ISSN
- 0168-8227 (ISSN-L)
- OpenAlex
- W2140334292
- Cited by
- 206
- References
- 22
- Citations by year
- 2026: 6 · 2025: 10 · 2024: 4 · 2023: 19 · 2022: 15 · 2021: 14 · 2020: 26 · 2019: 14 · 2018: 19 · 2017: 15 · 2016: 34 · 2015: 18 · 2014: 11 · 2013: 1
- FWCI
- 20.93
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Diabetes Research and Clinical Practice (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Keywords
- laparoscopic Roux-en-Y gastric bypass, type 2 diabetes, hypertension, obesity, exenatide, diabetes remission, insulin resistance, inflammation, cardiac structure, left ventricular mass, C-reactive protein, adiponectin, TNF-α
- MeSH terms
- Adult, C-Reactive Protein, Diabetes Mellitus, Type 2, Female, Glycated Hemoglobin, Humans, Hypertension, Male, Middle Aged, Obesity, Laparoscopy, Prognosis, Tumor Necrosis Factor-alpha, Gastric Bypass, Weight Loss, Body Mass Index
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