Effects of VLCD and Bariatric Surgery in Patients with Type 2 Diabetes
Research type
Research Study
Full title
DIFFERENTIAL EFFECTS OF VERY LOW CALORIE DIET (VLCD), ROUX-EN-Y-GASTRIC BYPASS AND SLEEVE GASTRECTOMY ON PANCREATIC, LIVER, MUSCLE AND HEART FAT DEPOSITION AND METABOLISM IN PEOPLE WITH TYPE 2 DIABETES: AN MRI STUDY
IRAS ID
295253
Contact name
Iskadar Idris
Contact email
Sponsor organisation
University of Nottingham
Duration of Study in the UK
2 years, 0 months, 31 days
Research summary
Research Summary
A promising recently-investigated and effective conservative approach to T2DM is through very-low-calorie diets (VLCD). Some studies have shown that the diabetic status of some patients can be reversed through VLCD. However, in patients undergoing bariatric surgery it is still debated whether it is the diet or the surgery that often follows this that causes diabetes remission.
The purpose of this project is to investigate the effects of a Very Low-Calorie Diet (VLCD) followed by two different bariatric surgical procedures, Roux-en-Y Gastric Bypass (RYGB) and Sleeve gastrectomy (SG) on skeletal muscle, liver and pancreatic fat deposition, ATP flux as well as cardiac function in Type 2 diabetes patients.
The two surgical procedures result in different metabolic and physical changes in the body. We will investigate if these surgical procedures cause differences in the diabetes remission process.
The Patients recruited to this study will be those already undergoing bariatric surgery as part of their standard care and who have type 2 diabetes.
Using Magnetic Resonance Imaging (MRI) and Magnetic Resonance Spectroscopy (MRS) and mixed meal tests (MMT), at various points through their surgical journey, (before and after the VLCD, 6 weeks post-surgery, and 4 months post-surgery) we will investigate the aforementioned changes.
This will give us an insight into how surgery and diet affect Type 2 diabetes status in those undergoing bariatric surgery.
The study procedures that are not a part of standard care (MRI, MRS, MMT) will be performed at the Sir Peter Mansfield Imaging Centre, University Park, University of Nottingham.Summary of Results
The study showed that all types of bariatric surgery causes weight loss and improvement in sugar control. This can be explained by the reduction in fat in the liver, improvement in the organ pancreas to produce insulin and the increase production of hormones from the bowel, namely the glucagon like peptide-1 to response to meal and therefore reduce appetite. When comparing different types of bariatric surgery, the study found that gastric bypass surgery improve diabetes control mainly by improving the response of the hormone GLP-1 to meals while gastrectomy improve diabetes control mainly by improving the ability of pancreas to produce insulin - thought to be driven primarily by loss of fat. Finally the study showed that the benefits of bariatric surgery to improve sugar control seemed to occur independent of calorie restriction prior to surgery.REC name
Wales REC 4
REC reference
21/WA/0387
Date of REC Opinion
23 Dec 2021
REC opinion
Further Information Favourable Opinion