OGTT One Year after Gastric Bypass and Sleeve Gastrectomy in Patients with Morbid Obesity and Type 2 Diabetes An RCT Oseberg Study Farhat Fatima MD Institute of Clinical Medicine Faculty of Medicine University of Oslo Oslo Norway ID: 933434
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Slide1
Slide2Glycaemia, Beta-Cell Function, and Incretin Hormones Post-OGTT One Year after Gastric Bypass and Sleeve Gastrectomy in Patients with Morbid Obesity and Type 2 Diabetes: An RCT (Oseberg Study)
Farhat Fatima, MDInstitute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
Slide3Key messages
Rates of type 2 diabetes remission were higher with gastric bypass compared to sleeve gastrectomy.Several features such as increased gastric emptying, better glucagon-like peptide 1 response, higher insulin secretion rate, and greater hepatic insulin sensitivity with gastric bypass may help to explain this finding.
Slide4Background (1)
What do we already know about this topic?The Oseberg (Obesity Surgery in Tonsberg) study was a randomized controlled, blinded study to compare the glycemic effects of sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB)1.
1.
Hofso
D, Fatima F,
Borgerass
H, et al. Gastric Bypass Versus Sleeve Gastrectomy in Patients With Type 2 Diabetes (Oseberg): A Single-Centre, Triple-Blind,
Randomised
Controlled Trial. Lancet Diabetes Endocrinol. 2019;7(12):912-924.
Slide5Background (2)
How was this study conducted?106 patients were enrolled and randomly assigned to RYGB (n=53) or SG (n=53).Patients had a mean (SD) age of 48 (10) years, body mass index (BMI) 42.3 (5.3) kg/m², HbA1c 66 (18) mmol/mol, and 72 (66%) were women.The primary endpoints were remission of type 2 diabetes (HbA1c <42 mmol/mol) with glucose lowering drugs and beta-cell function measured by Disposition Index, oral glucose tolerance test (
OGTT
) and intravenous glucose tolerance test (
IVGTT
).
Slide6Findings
What does this study add?T2D remission rates were higher in the RYGB group than in the SG group.Increased gastric emptying in the RYGB group appears to be associated with a better glucagon-like peptide 1 response and a higher insulin secretion rate.There was also greater hepatic insulin sensitivity in the RYGB group compared to SG possibly mediated by greater weight loss.
Slide7Perspectives
How does this study impact clinical practice?The Oseberg study demonstrated a higher 1-year remission rate of type 2 diabetes after RYGB than SG.Post-OGTT glucose levels were significantly lower after RYGB as compared with SG, possibly mediated by a greater increase in GIP, GLP-1 and C-peptide levels.These features may help explain the higher T2D remission rates with RYGB.