Metabolic outcomes 1 year after gastric bypass surgery in obese people with type 2 diabetes

To assess metabolic outcomes in obese people with type 2 diabetes [T2D] in the first year following gastric bypass surgery. Forty-nine obese patients with T2D who had undergone gastric bypass surgery 12 or more months previously were identified. Body weight and glycosylated haemoglobin [HbA[1c]] pre-operatively and 3, 6 and 12 months postoperatively, changes to glucose-lowering therapies, and blood pressure [BP] and total and high-density lipoprotein [HDL] cholesterol pre-operatively and 12 months postoperatively were recorded. The primary outcome measure was change in HbA[1c]; secondary outcomes included changes in BP and lipid profile. The mean pre-operative body weight was 141.4 kg, the body mass index 49.4 and HbA[1c] 8.1%. The mean postoperative percentage of excess body weight loss at 3, 6 and 12 months was 39.0, 53.9 and 71.1 with reduction in HbA[1c] to 6.6, 6.2 and 5.8%, respectively [p < 0.0001]. Remission of diabetes [HbA[1c] <6.5%] occurred in 12 of 18 patients [67%] at 3 months, 20 of 27 [74%] at 6 months and 21 of 25 [84%] at 12 months; of 41 patients under glucose-lowering treatment, 26 [63%] achieved complete withdrawal of treatment and 7 [17%] had their doses reduced. The mean of differences between baseline and 12-month measurements of systolic BP was 10.5 mm Hg [p = 0.021] and the total-to-HDL cholesterol ratio 0.9 [p < 0.002]. Our study confirmed the finding of previous studies that gastric bypass surgery in obese people with T2D results in significant weight loss, and improved glycaemic, BP and lipid profiles. Bariatric surgery should be regarded as an effective therapeutic intervention in this patient population

Early changes in thyroid-stimulating antibody activity following radio iodine therapy

The aim of this study was to determine whether or not the titre of thyroid-stimulating hormone receptor antibody with stimulating [TRAb-S] activity changes in patients with Graves' disease [GD] or toxic multinodular goitres [TMNG] 3 months after treatment with sodium iodide [131I]. Subjects and Serum specimens were obtained from 21 hyperthyroid patients [15 with GD and 6 with TMNG] at a median 0.5 months before and 3 months after 131I treatment using a standard ablative dose of 555 MBq. TRAb-S activity was measured in a sensitive and specific luminescent bioassay employing the lulu cell line and expressed as a stimulation index [SI; normal 1.5]. The mean TRAb-S in the GD patients was 2.72 SI [95% CI: 1.51-4.03] 0.5 months before administration of 131I and 3.98 SI [95% CI: 1.20-6.76] 3 months after administration of 131I. The difference was not statistically significant at p < 0.8. It was not elevated in the TMNG patients before [0.57 SI; 95% CI: 0.41- 0.73] and after [1.00 SI; 95% CI: 0.74-1.26] treatment either. Conclusions: Radioiodine therapy for GD or TMNG did not induce a significant change in TRAb-S activity at 3 months after treatment with 131I, probably due to effective antithyroid therapy or the timing of samples