Endoscopic Duodenal Mucosal Resurfacing for the Treatment of Type 2 Diabetes

2018 ◽  
Vol 36 (4) ◽  
pp. 322-324 ◽  
Author(s):  
Alia Hadefi ◽  
Vincent Huberty ◽  
Arnaud Lemmers ◽  
Marianna Arvanitakis ◽  
David Maggs ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Bypass Surgery ◽  
Metabolic Diseases ◽  
Invasive Procedure ◽  
Diabetic Patients ◽  
Intestinal Bypass ◽  
Alcoholic Fatty Liver ◽  
Glucose Homoeostasis ◽  
Alcoholic Fatty Liver Disease

Type 2 diabetes is a pandemic disease with an incidence that has risen steadily over recent decades. Experimental evidence in animals has demonstrated that intestinal bypass surgery of the upper small intestine, particularly the duodenum, has an important role in glucose homoeostasis. Furthermore, Roux-en-Y bypass performed as bariatric surgery has shown to correct hyperglycaemia from the first postoperative days in obese diabetic patients. Therefore, on the basis of these considerations, duodenal mucosal resurfacing was studied in type 2 diabetes patients as a minimally invasive procedure that could offer an alternative treatment for these patients. Further studies, and particularly large controlled trials, are needed to determine the place of this procedure in the treatment of type 2 diabetes as well as other metabolic diseases such as non-alcoholic fatty liver disease/non-alcoholic steatohepatitis.

scholarly journals Prevalence of non-alcoholic fatty liver disease in type-2 diabetes mellitus patients

2018 ◽  
Vol 6 (4) ◽  
pp. 1322 ◽  
Author(s):  
Hardik Patel ◽  
Yadav Narain Verma
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Diabetic Patients ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Background: Non-alcoholic fatty liver disease (NAFLD) is a common chronic condition of which diabetic fatty liver accounts for a large proportion, with 50 to 75% of the subjects demonstrating fat in the liver on ultrasound. As a result of epidemic increase in diabetes mellitus, hypertension, obesity and hyperlipidemia, the prevalence of NAFLD is increasing worldwide.Methods: A study was conducted on a total 100 type-2 diabetes mellitus patients attending Geetanjali Medical College and Hospital, Udaipur, Rajasthan. Patients with known chronic liver disease and history of alcohol intake were excluded. These patients were evaluated by abdominal ultrasonography to determine the presence of fatty liver. They were divided into fatty liver group and non-fatty liver group; and were further evaluated by measurement of body mass index, Central obesity, HbA1c and lipid profile. The data obtained was analyzed using SPSS version 20.0.Results: Of the 100 diabetic patients enrolled in this study, 64 (64%) presented with NAFLD. The highest prevalence of NAFLD was recorded in the age group of 50-59 years at 37.5%. The prevalence rate among males (65.62%) was higher than for females (34.38%). A comprised NAFLD patients (64%) and Non-NAFLD patients (34%).Conclusions: This study revealed that the NAFLD is a vital part of cluster of abnormalities such as dysglycemia, dyslipidemia, hypertension and obesity. Age and duration of diabetes are also important contributing factors in occurrence of NAFLD.

scholarly journals Non-Alcoholic Fatty Liver Disease in Patients with Type 2 Diabetes: Evaluation of Hepatic Fibrosis and Steatosis Using Fibroscan

Diagnostics ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. 159 ◽  
Author(s):  
Tran Thi Khanh Tuong ◽  
Dang Khoa Tran ◽  
Pham Quang Thien Phu ◽  
Tong Nguyen Diem Hong ◽  
Thien Chu Dinh ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Liver Steatosis ◽  
Diabetic Patients ◽  
Advanced Fibrosis ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Patients with type 2 diabetes mellitus (T2DM) are at increased risk of non-alcoholic fatty liver disease (NAFLD) and might eventually progress to advanced fibrosis, cirrhosis and hepatocellular carcinoma (HCC). Recommendations on whether to screen for NAFLD in diabetic patients remains conflicted between major guidelines. Transient elastography using FibroScan with CAP (controlled attenuation parameter) can assess both liver steatosis and fibrosis simultaneously. This paper took a new look at the prevalence of NAFLD and the severity of fibrosis among T2DM patients in Vietnam. The study was conducted using a cross-sectional design in T2DM adults who attended Dai Phuoc Ho Chi Minh Polyclinic and Polyclinic of Pham Ngoc Thach University of Medicine. Liver steatosis and fibrosis was assessed by FibroScan. NAFLD was diagnosed if CAP > 233 dB/m (steatosis > 5%). Data were analyzed using STATA 12 software program. We found that a total of 307 type 2 diabetic patients qualified for the study’s criteria. The prevalence of NAFLD in T2DM patients based on FibroScan was 73.3%. Rates of mild, moderate and severe steatosis were 20.5%, 21.8% and 30.9%, respectively. The prevalence of significant fibrosis (≥ F2), advanced fibrosis (≥ F3) and cirrhosis (F4) was 13.0%, 5.9% and 3.6%, respectively. On multivariate analysis, aspartate aminotransferase (AST) (OR: 1.067; 95% CI: 1.017–1.119; p = 0.008) and platelet levels (OR: 0.985; 95% CI: 0.972–0.999; p = 0.034) were independent of risk factors of advanced fibrosis. Thus, our study supports screening for NAFLD and for evaluating the severity of liver fibrosis in T2DM patients.

scholarly journals Effect of sodium-glucose cotransporter 2 inhibitor in patients with non-alcoholic fatty liver disease and type 2 diabetes mellitus: a propensity score-matched analysis of real-world data

2021 ◽  
Vol 12 ◽  
pp. 204201882110002
Author(s):  
Taeang Arai ◽  
Masanori Atsukawa ◽  
Akihito Tsubota ◽  
Shigeru Mikami ◽  
Hiroki Ono ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Propensity Score ◽  
Fatty Liver Disease ◽  
Liver Inflammation ◽  
Alcoholic Fatty Liver ◽  
Sodium Glucose Cotransporter ◽  
Alcoholic Fatty Liver Disease

Background: Although sodium-glucose cotransporter 2 inhibitors (SGLT2-Is) improve not only glycemic control but also liver inflammation and fatty changes in patients with non-alcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus (T2DM), its sustainability and effect on liver fibrosis have remained unclear. The current study aimed to clarify the effects of 48-week SGLT2-I therapy on liver inflammation, fatty changes, and fibrosis in NAFLD patients with T2DM. Methods: This study evaluated the effects of SGLT2-I on NAFLD, including liver fibrosis assessed via transient elastography, in 56 patients with NAFLD who received SGLT2-I for 48 weeks. Moreover, changes in each clinical parameter between patients receiving SGLT2-I (the SGLT2-I group) and those receiving other oral hypoglycemic agents (OHAs) (the non-SGLT2-I group) were compared, using 1:1 propensity score matching to adjust for baseline factors. Results: The SGLT2-I group exhibited a significant decrease in controlled attenuation parameter (312 dB/m at baseline to 280 dB/m at week 48) and liver stiffness measurement (9.1–6.7 kPa) ( p < 0.001 for both). After propensity score matching (44 patients each in the SGLT2-I and non-SGLT2-I groups), no significant difference in HbA1c decrease was observed between the two groups. However, compared with the non-SGLT2-I group, the SGLT2-I group showed a significant decrease in body weight ( p < 0.001), alanine aminotransferase ( p = 0.02), uric acid ( p < 0.001), and Fibrosis-4 (FIB-4) index ( p = 0.01) at week 48. The improvement in FIB-4 index, defined as a ⩾10% decline from baseline at week 48, was 56.8% (25/44) in the SGLT2-I group and 20.5% (9/44) in the non-SGLT2-I group ( p < 0.001). Conclusion: SGLT2-Is improved not only glycemic control but also liver fatty infiltration and fibrosis in patients with NAFLD and T2DM, suggesting their possible superiority to other OHAs concerning these effects.

Dapagliflozin reduces hepatic and visceral fat in type‐2 diabetes patients with non‐alcoholic fatty liver disease

2021 ◽  
Author(s):  
Susrichit Phrueksotsai ◽  
Kanokwan Pinyopornpanish ◽  
Juntima Euathrongchit ◽  
Apinya Leerapun ◽  
Arintaya Phrommintikul ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Visceral Fat ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease ◽  
Diabetes Patients

scholarly journals Non‐alcoholic fatty liver disease in type 2 diabetes – A specific entity?

2021 ◽  
Vol 41 (S1) ◽  
pp. 105-111
Author(s):  
Benjamin Schröder ◽  
Sabine Kahl ◽  
Michael Roden
Keyword(s):  
Type 2 Diabetes ◽  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease
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