• About
  • Masthead
  • License Content
  • Advertise
  • Submit Press Release
  • RSS/Email List
  • Write for us
  • Contact us
2 Minute Medicine
No Result
View All Result

No products in the cart.

SUBSCRIBE
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
2 Minute Medicine
  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • AccountLog-in/out
    • Subscribe
    • Sign-in
    • My account
SUBSCRIBE
2 Minute Medicine
Subscribe
Home All Specialties Chronic Disease

Gastric bypass surgery more effective than medical therapy alone for achieving microalbuminuria remission in Type 2 Diabetes

byTeddy GuoandMarc Succi, MD
June 8, 2020
in Chronic Disease, Endocrinology, Nephrology, Surgery, Urology
Reading Time: 3 mins read
0
Share on FacebookShare on Twitter

1. Patients who underwent Roux-en-Y gastric (RYGB) surgery had higher rates of microalbuminuria remission when compared to those who received only medical treatment at 24 months post-intervention.

2. Patients who underwent RYGB surgery also showed improvements in metabolic control outcomes (HbA1C, LDL-C, triglycerides, and change in total body weight) when compared to those who received only medical treatment, while having a similar safety profile. 

Evidence Rating Level: 1 (Excellent) 

Study Rundown: The management of type 2 diabetes (T2D) and chronic kidney disease (CKD) through pharmacotherapy has shown promising advancements in recent years. However, despite these improvements in the best available medical therapies, many obese T2D patients still suffer from progressive CKD. This study compared the effects between RYGB surgery and the best medical therapies on lowering microalbuminuria in obese T2D patients with early CKD. Findings suggest that 24 months post-intervention, RYGB surgery was more effective than the best medical treatments at reducing microalbuminuria and early CKD severity in a population of obese type 2 diabetics while maintaining a comparable safety profile. Through their sex-stratified, computer-generated randomizer, the researchers were able to successfully obtain two groups with comparable demographic and clinical baseline characteristics. In addition, follow-ups were frequent, but still maintained a high patient turnout throughout the study. A limitation worth noting is that patients in the RYGB group were not exclusively treated with the surgical intervention. Indeed, many patients who underwent RYGB surgery were also administered antihypertensives and glucose-regulating medications, as needed, similar to the medical treatment-only group.

Click to read the study in JAMA Surgery 

Relevant Reading: Effect of Bariatric Surgery on CKD Risk

In-Depth [randomized controlled trial]: This randomized clinical trial enrolled 100 patients from a single center between April 1, 2013 and March 31, 2016. Patients were between 18 and 65 years of age with pre-established microalbuminuria, T2D, and obesity. More specifically, patients were enrolled if they met the following criteria: urinary albumin-creatinine ratio (uACR) greater than 30 mg/g, T2D with HbA1C <12%, BMI of 30 to 35 kg/m2, and classification of having stage G1 to G3 and A2 to A3 CKD. Patients were randomized to the best medical treatment (BMT) or RYGB surgery intervention group. All surgeries were performed by the same surgeon. The primary outcome was remission of uACR levels, defined as levels <30 mg/g. Secondary outcomes included, but were not limited to, HbA1C levels, mean percentage change in body weight, and occurrence of adverse events. Patients were assessed at one and four weeks after being randomized, and then in three-month intervals until the end of the 24-month period. After 24 months, an intention-to-treat analysis indicated that uACR remission was achieved in 82% of RYGB patients (95% confidence interval [CI], 72 to 93%) compared to 55% in BMT patients (95% CI, 39 to 70%; P = 0.006). In addition, HbA1C levels were reduced in the RYGB group compared to the BMT group with a mean difference of -0.54% (95% CI, -1.07 to -0.004; P = 0.048). Mean percentage change in total body weight in the RYGB group was -25.4% (95% CI, -26.9 to -23.8%) and -4.5% in the BM group (95% CI, -6.1 to -3.1%). Furthermore, serious adverse events occurred with equal frequency between the RYGB (13%) and BMT (13%) groups (P > 0.99), suggesting a comparable safety profile. All in all, RYGB surgery was more effective than BMT at achieving uACR remission, while also improving metabolic targets in obese type 2 diabetics with CKD.

RELATED REPORTS

Comprehensive telehealth intervention effective for reducing HbA1c in poorly controlled diabetes

Tirzepatide reduces body weight and improves cardiometabolic function in patients with obesity

Discrepancies exist between measured and estimated glomerular filtration rate

Image: PD

©2020 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.

Tags: chronic kidney diseasediabetesgastric bypassmicroalbuminuriaRYGB
Previous Post

Relugolix treatment significantly decreases testosterone levels in advanced prostate cancer

Next Post

2 Minute Medicine Rewind June 8, 2020

RelatedReports

Chronic Disease

Comprehensive telehealth intervention effective for reducing HbA1c in poorly controlled diabetes

August 2, 2022
Many new pediatric asthma cases attributable to obesity
Cardiology

Tirzepatide reduces body weight and improves cardiometabolic function in patients with obesity

July 22, 2022
Significant reduction in prostate screening rates after revised guidelines
Chronic Disease

Discrepancies exist between measured and estimated glomerular filtration rate

July 18, 2022
Being overweight and obese associated with increased incidence of chronic kidney disease
Cardiology

Comparisons of invasive versus conservative management in chronic kidney disease in the ISCHEMIA-CKD trials

July 7, 2022
Next Post
Risk of autism in offspring linked to maternal pregestational diabetes and severe obesity

2 Minute Medicine Rewind June 8, 2020

Behavioral dysregulation in infancy predicts later child mental health

39·0°C versus 38·5°C ear temperature as fever limit in children with neutropenia undergoing chemotherapy for cancer: A multicentre, cluster-randomised, multiple-crossover, non-inferiority trial

Late gestation antidepressant use linked to postpartum hemorrhage

Indirect effects of COVID-19 estimated to lead to tens of thousands of additional maternal and child deaths

License Our Award-Winning Physician-Written Medical News and Visual Abstracts

2 Minute Medicine is the leading authoritative medical news licensing service, and the only with reports written by practicing doctors.

LICENSE CONTENT

2MM+ Premium Access

No ads & unlimited access to all current reports, over 9000 searchable archived reports, visual abstracts, Weekly Rewinds, and the online edition of The Classics Series™ textbook.

Subscription Options
2 Minute Medicine

2 Minute Medicine® is an award winning, physician-run, expert medical media company. Our content is curated, written and edited by practicing health professionals who have clinical and scientific expertise in their field of reporting. Our editorial management team is comprised of highly-trained MD physicians. Join numerous brands, companies, and hospitals who trust our licensed content.

Recent Reports

  • Methamphetamine use associated with cardiovascular disease in hospitalized patients
  • Management of uncomplicated urinary tract infections amongst women in the United States Military Health System highly concordant with guidelines
  • Gout flares associated with a transient increase in subsequent risk of cardiovascular events
License Content
Terms of Use | Disclaimer
Cookie Policy
Privacy Statement (EU)
Disclaimer

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.

  • Specialties
    • Cardiology
    • Chronic Disease
    • Dermatology
    • Emergency
    • Endocrinology
    • Gastroenterology
    • Imaging and Intervention
    • Infectious Disease
    • Nephrology
    • Neurology
    • Obstetrics
    • Oncology
    • Ophthalmology
    • Pediatrics
    • Preclinical
    • Psychiatry
    • Public Health
    • Pulmonology
    • Rheumatology
    • Surgery
  • Wellness
  • Classics™
    • 2MM+ Online Access
    • Paperback and Ebook
  • Rewinds
  • Visual
  • Partners
    • License Content
    • Submit Press Release
    • Advertise with Us
  • Account
    • Subscribe
    • Sign-in
    • My account

© 2021 2 Minute Medicine, Inc. - Physician-written medical news.