Vitamin D Levels as an Important Predictor for Type 2 Diabetes Mellitus and Weight Regain Post-Sleeve Gastrectomy

The Impact of Bariatric Surgery on Type 2 Diabetes Mellitus Remission: A Systematic Review

Bariatric surgery has been shown to significantly affect type 2 diabetes mellitus (T2DM) remission, particularly in obese individuals. This systematic review aims to evaluate the effectiveness of bariatric surgical interventions in inducing remission of T2DM as well as to identify factors influencing surgical outcomes. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed across multiple databases, including PubMed, Embase, and Cochrane Library, utilizing text words and controlled vocabulary in various combinations with Boolean operators "AND" and "OR." The search was limited to open-access, full-text articles in English published from 2005 to 2024, including studies involving human subjects. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. In the study selection process for the systematic review, records were initially identified from three databases: Cochrane (31 records), Embase (62 records), and PubMed (52 records). This yielded 145 records. After removing 107 records, 38 records remained for screening. Of these, five records were excluded based on irrelevant problems and irrelevant outcomes. Subsequently, 33 reports were sought for full-text retrieval, with all reports being retrievable. The 33 reports were assessed for eligibility. Out of these, six were excluded due to an inaccessible full-text record. Finally, 33 studies met the inclusion criteria and were included in the review. Bariatric surgery is a highly effective intervention for individuals with T2DM, particularly those with obesity. It leads to significant weight loss and improved glycemic control through mechanisms that reduce stomach size and alter hormonal responses. This surgery not only helps many patients achieve remission from diabetes but also decreases the risk of obesity-related health issues. Beyond physical health, patients often report enhanced psychological well-being and quality of life. Overall, bariatric surgery can transform the health trajectory of select individuals, offering them a renewed sense of control and improved overall health.

Diagnostic Value of Advanced-DiaRem for Predicting Diabetic remission after One Anastomosis Gastric Bypass/Minigastric Bypass

BACKGROUND

Obesity is a main risk factor for type 2 diabetes. Bariatric surgery can help diabetic patients with obesity. Among different types of metabolic surgeries, one anastomosis gastric bypass (OAGB) surgery is a new procedure.

AIM

To comprehensively determine the diagnostic values of advanced-diabetic remission (Ad-DiaRem), one of the scoring systems, in predicting diabetic remission after OAGB surgery.

METHODS

In this retrospective cohort study, patients aged 18-60 years with type 2 diabetes and obesity, who had undergone OAGB surgery, were included. Diagnostic values of Ad-DiaRem on diabetes remission, after OAGB surgery, which consist of sensitivity (Sen), specificity (Spe), positive and negative predictive values (P/NPV), positive and negative likelihood ratios (P/NLR), accuracy, and odd ratio (OR), were determined.

RESULTS

The percentages of complete diabetic remission after surgery were 56.3% and 53.8% in 12th and 24th months, respectively. The remission cut-off point for Ad-DiaRem was defined 10 considering the highest Youden's index. Among the evaluation indices, the values of Spe, PPV, accuracy, and OR were assigned a high value in both 12th and 24th months of follow-up; however, the area under curve (AUC) was 20% in both.

CONCLUSION

According to our findings, the model of diagnostic values of Ad-DiaRem for predicting diabetic remission should be specified according to race, place of residence, and prevalence of diabetes in society. Presently, this model can be used cautiously until a new model is proposed by further studies.

The Effect of Vitamin D Supplementation on the Severity of Symptoms and the Quality of Life in Irritable Bowel Syndrome Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Irritable bowel syndrome (IBS), a gastrointestinal disorder affecting 7-12% of the population, is characterized by abdominal pain, bloating, and alternating bowel patterns. Data on risk and protective influences have yielded conflicting evidence on the effects of alternative interventions, such as vitamin D. This review focuses on the effects of vitamin D on IBS. A systematic review and meta-analysis considered all articles published until 4 April 2022. The search for randomized controlled trials assessing vitamin D efficacy in IBS with outcomes, primary (Irritable Bowel Severity Scoring System (IBS-SSS)) and secondary (IBS quality of life (IBS-QoL) and serum level of calcifediol (25(OH)D)), was performed on six databases, Google Scholar, Web of Science, SCOPUS, EMBASE, PubMed (MEDLINE), and Cochrane Central Register of Controlled Trials. We included six trials with 616 patients. The pooled analysis found no difference between vitamin D and placebo in improving IBS-SSS (MD: -45.82 with 95% CI [-93.62, 1.98], p = 0.06). However, the pooled analysis favored vitamin D over placebo in improving the IBS-Qol (MD: 6.19 with 95% CI [0.35, 12.03], p = 0.04) and serum 25(OH)D (MD: 25.2 with 95% CI [18.41, 31.98], p = 0.00001). Therefore, further clinical trials are required to reach clinically applicable and generalizable findings.