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Rodanaki, M., Rask, E. & Lodefalk, M. (2025). Effect of a GnRH injection on kisspeptin levels in girls with suspected precocious puberty: a randomized-controlled pilot study. Journal of Pediatric Endocrinology & Metabolism (JPEM), 38(3), 288-291
Open this publication in new window or tab >>Effect of a GnRH injection on kisspeptin levels in girls with suspected precocious puberty: a randomized-controlled pilot study
2025 (English)In: Journal of Pediatric Endocrinology & Metabolism (JPEM), ISSN 0334-018X, E-ISSN 2191-0251, Vol. 38, no 3, p. 288-291Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Kisspeptin plays a major role in the onset of puberty by stimulating the gonadotropin-releasing hormone (GnRH) neurons. The aim of this study was to investigate whether GnRH inhibits kisspeptin secretion via a negative feedback mechanism and potential associations between kisspeptin levels and other hormones of importance for pubertal onset.

METHODS: Thirteen girls with suspected central precocious puberty underwent a GnRH stimulation test twice in a randomized, placebo-controlled manner. Blood was sampled up to 150 min after an IV injection of either Relefact LHRH® or saline. The levels of kisspeptin, acylated ghrelin, ultrasensitive oestradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), insulin and glucose were analysed.

RESULTS: Baseline kisspeptin levels ranged from 9.9 to 201.6 pg/mL. Neither area under the curve for kisspeptin levels nor peaks were significantly lower after the GnRH injection compared to placebo. Baseline kisspeptin and glucose levels tended to be associated (rho=0.55, p=0.051) but no other associations were found between kisspeptin and other hormones.

CONCLUSIONS: Basal levels of kisspeptin vary widely in young girls. We found no evidence of a negative feedback mechanism of GnRH on kisspeptin in this small pilot study. The suggested association between kisspeptin and glucose levels needs further investigations.

Place, publisher, year, edition, pages
Freund Publishing House, Ltd., 2025
Keywords
Gonadotropin-releasing hormone, hypothalamic-pituitary-gonadal axis, kisspeptin, precocious puberty
National Category
Pediatrics Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-118847 (URN)10.1515/jpem-2024-0606 (DOI)001402565800001 ()39847034 (PubMedID)2-s2.0-85216375354 (Scopus ID)
Funder
Region Örebro CountySjukvårdsregionala forskningsrådet Mellansverige
Available from: 2025-01-27 Created: 2025-01-27 Last updated: 2025-04-28Bibliographically approved
Jans, A., Rask, E., Ottosson, J., Szabo, E. & Stenberg, E. (2025). Prevalence of dumping and hypoglycaemia symptoms after bariatric surgery: A questionnaire-based cross-sectional study. Clinical Obesity, 15(1), Article ID e12709.
Open this publication in new window or tab >>Prevalence of dumping and hypoglycaemia symptoms after bariatric surgery: A questionnaire-based cross-sectional study
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2025 (English)In: Clinical Obesity, ISSN 1758-8103, E-ISSN 1758-8111, Vol. 15, no 1, article id e12709Article in journal (Refereed) Published
Abstract [en]

Dumping and post-bariatric hypoglycaemia (PBH) are side effects that occur after bariatric surgery. The aim of this study was to estimate the prevalence of dumping and PBH symptoms before Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) at 6 months, 1 year, 2 years and 5 years after surgery in a Swedish population. A cross-sectional single-centre study was performed at Lindesberg Hospital, Region Örebro County, Sweden, between 2020 and 2023. The Swedish version of the Dumping Severity Scale (DSS-Swe) questionnaire, which includes eight items regarding dumping symptoms and six items regarding hypoglycaemia symptoms, was used. A total of 742 DSS-Swe questionnaires were included. The average age at surgery was 42.0 years (standard deviation [SD] = 11.9), and the average body mass index was 41.8 kg/m2 (SD = 5.9). The surgical methods consisted of RYGB (66.3%) and SG (33.7%). The proportion of RYGB patients with highly suspected dumping increased from 4.9% before surgery to 26.3% (adjusted odds ratio [OR] = 7.35, 95% confidence interval [CI] = 3.08-17.52) at the 5-year follow-up. PBH symptoms increased from 1.4% before surgery to 19.3% at the 5-year follow-up (adjusted OR = 17.88, 95% CI = 4.07-78.54). For SG patients, no significant increase in dumping or PBH symptoms was observed. In patients with persistent type 2 diabetes (T2D), there were no cases of highly suspected hypoglycaemia following RYGB or SG. Symptoms of dumping and PBH were common after RYGB, while no clear increase was observed after SG. Persistent T2D seems to be a protective factor against PBH symptoms.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
Bariatric surgery, dumping, hypoglycaemia, prevalence, questionnaire
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-116682 (URN)10.1111/cob.12709 (DOI)001329892300001 ()39392055 (PubMedID)2-s2.0-85205961752 (Scopus ID)
Funder
Region Örebro County, OLL-967454Region Örebro County, OLL-993314Region Örebro County, OLL-939106Bengt Ihres Foundation
Available from: 2024-10-11 Created: 2024-10-11 Last updated: 2025-01-16Bibliographically approved
Jans, A., Rask, E., Ottosson, J., Magnuson, A., Szabo, E. & Stenberg, E. (2023). Reliability of the DSS-Swe Questionnaire. Obesity Surgery, 33(11), 3487-3493
Open this publication in new window or tab >>Reliability of the DSS-Swe Questionnaire
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2023 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 33, no 11, p. 3487-3493Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Symptomatic postbariatric hypoglycemia (PBH) is a known complication that can occur a few years after Roux-en-Y gastric bypass (RYGB). There is currently no established rating scale for PBH-associated symptoms developed for use in Swedish populations. The aim of the study was to translate an already existing questionnaire into Swedish and to test its reliability.

METHODS: The study included forward and backward translations of the original Dumping Severity Scale (DSS) questionnaire with 8 items regarding symptoms of early dumping and 6 items regarding hypoglycemia, with each item graded on a 4-point Likert scale. The reliability of the Swedish translated questionnaire (DSS-Swe) was estimated using internal consistency and test-retest methods.

RESULTS: A total of 200 patients were included in the study. Good internal consistency was demonstrated regarding the items related to early dumping symptoms, with a Cronbach's alpha coefficient of 0.82, and very good agreement in terms of test-retest reliability, with an overall intraclass correlation coefficient (ICC) of 0.91 (95% CI 0.88-0.93). The items related to hypoglycemia yielded a good Cronbach's alpha coefficient of 0.76 and an ICC of 0.89 (95% CI 0.85-0.91).

CONCLUSION: The DSS-Swe questionnaire shows good reliability regarding both internal consistency and test-retest performance for use in Swedish populations.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Bariatric surgery, Hypoglycemia, Questionnaire, Reliability test, Translation
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-108819 (URN)10.1007/s11695-023-06841-7 (DOI)001081587000001 ()37798509 (PubMedID)2-s2.0-85173778883 (Scopus ID)
Available from: 2023-10-10 Created: 2023-10-10 Last updated: 2025-01-21Bibliographically approved
Rodanaki, M., Rask, E. & Lodefalk, M. (2022). A Randomized Trial of the Effect of a GnRH Analogue Injection on Ghrelin Levels in Girls. Hormone Research in Paediatrics, 95(5), 442-451
Open this publication in new window or tab >>A Randomized Trial of the Effect of a GnRH Analogue Injection on Ghrelin Levels in Girls
2022 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 95, no 5, p. 442-451Article in journal (Refereed) Published
Abstract [en]

Introduction: Ghrelin concentrations decline during puberty by an unclear mechanism. Acylated ghrelin (AG) is unstable in sampling tubes, but no standardized sampling protocol exists. We hypothesized that ghrelin levels decrease as a consequence of increased gonadotropin-releasing hormone (GnRH) signalling and that the addition of a protease inhibitor to sampling tubes preserves the AG levels.

Methods: In this randomized, placebo-controlled, cross-over study, 13 girls with suspected central precocious puberty were included. They performed an adjusted GnRH stimulation test twice and were given Relefact LHRH (R)(100 mu g/m(2)) or saline in a randomized order. Blood was sampled repeatedly for 150 min for the analysis of hormone concentrations. Oestradiol levels were only measured at baseline. The protease inhibitor 4-(2-aminoethyl) benzenesulfonyl fluoride hydrochloride (AEBSF) was added to the sampling tubes. Specific ELISA kits were used for the analysis of AG and desacylated ghrelin (DAG) levels.

Results: Neither AG nor DAG levels changed after GnRH analogue injection in comparison to saline. The addition of AEBSF preserved AG levels (650.1 +/- 257.1 vs. 247.6 +/- 123.4 pg/mL, p < 0.001) and decreased DAG levels (51.9 [12.5-115.7] vs. 143.5 [71.4-285.7] pg/mL, p < 0.001). Both AG and DAG levels were inversely associated with insulin levels (r = -0.73, p = 0.005, and r = -0.78, p = 0.002, respectively). AG levels were inversely associated with oestradiol levels (rho = -0.57, p = 0.041).

Conclusion: Ghrelin levels do not decrease following a pharmacological dose of a GnRH analogue in the short term in girls. Addition of a protease inhibitor to the sampling tubes decreases AG degradation, resulting in preserved AG and decreased DAG levels. (C) 2022 The Author(s). Published by S. Karger AG, Basel

Place, publisher, year, edition, pages
S. Karger, 2022
Keywords
Acylated ghrelin, Central precocious puberty, Desacylated ghrelin, GnRH analogue, Protease inhibitor
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
urn:nbn:se:oru:diva-102574 (URN)10.1159/000526147 (DOI)000886610700006 ()35896083 (PubMedID)2-s2.0-85142001007 (Scopus ID)
Note

Funding agencies:

Research Committee and ALF funding, Region Örebro County, Sweden

Regional Research Council Mid Sweden

Available from: 2022-12-07 Created: 2022-12-07 Last updated: 2025-05-06Bibliographically approved
Rodanaki, M., Rask, E. & Lodefalk, M. (2022). Delayed puberty in boys in central Sweden: an observational study on diagnosing and management in clinical practice. BMJ Open, 12(2), Article ID e057088.
Open this publication in new window or tab >>Delayed puberty in boys in central Sweden: an observational study on diagnosing and management in clinical practice
2022 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 2, article id e057088Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To compare the usefulness of the classical definition of delayed puberty (DP) in boys with puberty nomograms and to describe the management of DP in boys in a hospital-based setting.

STUDY DESIGN: Observational retrospective multicentre study with a short-term follow-up.

SETTING AND PARTICIPANTS: Boys diagnosed with DP during 2013-2015 at paediatric departments in four counties in central Sweden. The medical records of 165 boys were reviewed.

PRIMARY AND SECONDARY OUTCOME MEASURES: Number of boys with DP after re-evaluation of the diagnosis according to the classical definition in comparison with puberty nomograms. Description of investigations performed and treatment provided to boys with DP.

RESULTS: In total, 45 and 58 boys were found to have DP according to the classical definition and the nomograms, respectively. Biochemical and/or radiological testing was performed in 91% of the 58 boys, but an underlying disease was only found in 9% of them. Approximately 79% of the boys received testosterone treatment, either as injections of testosterone enanthate or as testosterone undecanoate.

CONCLUSIONS: Puberty nomograms may be helpful instruments when diagnosing pubertal disorders in boys as they are not limited to an age close to 14 years and also identify boys with pubertal arrest. The majority of boys with DP undergo biochemical or radiological examinations, but underlying diseases are unusual emphasising the need for structural clinical practice guidelines for this patient group.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2022
Keywords
Community child health, paediatric endocrinology, paediatrics
National Category
Pediatrics
Identifiers
urn:nbn:se:oru:diva-97237 (URN)10.1136/bmjopen-2021-057088 (DOI)000754022100037 ()35115358 (PubMedID)2-s2.0-85123973730 (Scopus ID)
Funder
Region Örebro County
Available from: 2022-02-07 Created: 2022-02-07 Last updated: 2025-05-06Bibliographically approved
Rodanaki, M., Rask, E. & Lodefalk, M. (2022). The effect of a GnRH analogue injection on the circulating levels of kisspeptin-1 in girls with suspected central precocious puberty. Paper presented at 60th Annual Meeting of the European Society for Paediatric Endocrinology (ESPE), Rome, Italy, September 15–17, 2022. Hormone Research in Paediatrics, 95(Suppl. 2), 341-341, Article ID P1-151.
Open this publication in new window or tab >>The effect of a GnRH analogue injection on the circulating levels of kisspeptin-1 in girls with suspected central precocious puberty
2022 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 95, no Suppl. 2, p. 341-341, article id P1-151Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: Kisspeptin stimulates the gonadotropin releasing hormone (GnRH) neurons in hypothalamus initiating puberty. However, it is not known whether GnRH inhibits kisspeptin secretion by negative feedback and whether there are any associations between circulating levels of kisspeptin and other hormones, like ghrelin, important for the onset of puberty.

Methods: Thirteen girls with suspected central precocious puberty performed an adjusted GnRH stimulation test twice, placebo-controlled in a randomized order, at Örebro or Uppsala University Hospital, Sweden. Blood was sampled 0, 30, 60, 90, 120 and 150 min after the iv injection of either Relefact LHRH® or saline. The protease inhibitor 4-(2-aminoethyl) benzenesulfonyl fluoride hydrochloride (AEBSF) was added to the sampling tubes to a final concentration of 2 mg/ml. An ELISA kit from LifeSpan BioSciences, Inc. (No LS-F8231) was used for the analyses of Kisspeptin-1 levels. The levels of acylated ghrelin were analyzed with Millipore® Human Ghrelin (Active) ELISA kit (#EZGRA-88K). Serum ultrasensitive estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), insulin and glucose levels were analyzed using the usual clinical methods.

Results: The median Kisspeptin-1 level at baseline was 39 pg/ml (min–max: 0.1–221.3 pg/ml). The area-under-the curve for Kisspeptin-1 levels was not significantly lower after the GnRH injection as compared to the placebo injection. We did not find any significant correlations between the levels of kisspeptin-1 and acylated ghrelin, estradiol, LH, FSH, or insulin. However, we could see a positive correlation between kisspeptin-1 and glucose levels at baseline (Spearman’s rank test, rho = 0.63, p=0.021).

Discussion: We did not find evidence of a negative feedback mechanism between GnRH and kisspeptin in girls with suspected central precocious puberty since the circulating levels of kisspeptin-1 were unaffected by an intravenous injection of a GnRH analogue. However, paracrine actions in the hypothalamus cannot be ruled out by this study. The positive correlation found between kisspeptin-1 and glucose levels is in accordance with previous findings in both adults and children, suggesting a possible role for kisspeptin signaling in glucose metabolism.

Place, publisher, year, edition, pages
S. Karger, 2022
National Category
Endocrinology and Diabetes Pediatrics
Identifiers
urn:nbn:se:oru:diva-101712 (URN)000854435701258 ()
Conference
60th Annual Meeting of the European Society for Paediatric Endocrinology (ESPE), Rome, Italy, September 15–17, 2022
Available from: 2022-10-12 Created: 2022-10-12 Last updated: 2025-04-28Bibliographically approved
Rodanaki, M., Rask, E. & Lodefalk, M. (2021). Adding a protease inhibitor to sampling tubes increases the acylated ghrelin and decreases the desacylated ghrelin levels in girls. Paper presented at 59th Annual Meeting of the European Society for Paediatric Endocrinology (ESPE 2021 Online), September 22-26, 2021. Hormone Research in Paediatrics, 94(Suppl. 1), 111-112
Open this publication in new window or tab >>Adding a protease inhibitor to sampling tubes increases the acylated ghrelin and decreases the desacylated ghrelin levels in girls
2021 (English)In: Hormone Research in Paediatrics, ISSN 1663-2818, E-ISSN 1663-2826, Vol. 94, no Suppl. 1, p. 111-112Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Introduction: Ghrelin is a growth hormone-releasing acylated peptide stimulating the appetite, mainly produced in the stomach, and with an important role in pubertal development (1). Two ghrelin forms have been described, acylated (AG) and desacylated (DAG), but it is debated whether DAG is an active hormone or a degradation product of AG (2). Our aim was to evaluate the effects of adding the protease inhibitor 4-(2-aminoethyl) benzenesufonyl fluoride hydrochloride (AEBSF) to sampling tubes and acidification of plasma on levels of AG and DAG in girls with suspected central precocious puberty (CPP).

Methods: 13 girls aged 6.6 to 10.1 years with suspected CPP undergoing a gonadotropin-releasing hormone stimulation test during 2015-2017 at the Departments of Paediatrics, at Örebro or Uppsala University Hospital were included. Blood samples were collected at 0 min in precooled EDTA tubes with or without AEBSF at a final concentration of 2mg/ml. After cold centrifugation, HCl at a final concentration of 50 μmol/l, was added to 50% of the plasma tubes containing AEBSF. The AG and DAG concentrations were measured by ELISA kits. Comparison was performed using one-way ANOVA for repeated measurements.

Results: The mean plasma AG levels were significantly higher after the addition of AEBSF only (650.9 +/- 257.1 pg/ml) or AEBSF+HCl (681.2 +/- 299 pg/ml) compared to the concentrations without additives (247.6 +/- 123.4 pg/ml, p<0.01 for both comparisons). There was no significant difference between the AG levels after AEBSF and AEBSF+HCl addition. The plasma levels of DAG were significantly lower after the addition of AEBSF+HCl (69.3 +/- 30.6 pg/ml) and even further lowered after the addition of AEBSF only (56.3+/- 30.9 pg/ml) compared to the concentrations of DAG in tubes without any additives (149.9 +/- 73.7 pg/ml, p < 0.01 for both comparisons).

Discussion: Due to the unstable nature of AG, special procedures are required for accurate measurement of its plasma levels in children, including the use of a protease inhibitor like AEBSF. However, DAG was still measurable indicating that it may not only be a degradation product of AG. 1. Kojima M, Kangawa K. Ghrelin: structure and function. Physiol Rev. 2005;85(2):495-522.2. Blatnik M, Soderstrom CI, Dysinger M, Fraser SA. Prandial ghrelin attenuation provides evidence that des-acyl ghrelin may be an artifact of sample handling in human plasma. Bio-analysis. 2012;4(20):2447-55.

Place, publisher, year, edition, pages
S. Karger, 2021
National Category
Pediatrics Endocrinology and Diabetes
Identifiers
urn:nbn:se:oru:diva-94889 (URN)000696302600200 ()
Conference
59th Annual Meeting of the European Society for Paediatric Endocrinology (ESPE 2021 Online), September 22-26, 2021
Available from: 2021-10-13 Created: 2021-10-13 Last updated: 2025-04-28Bibliographically approved
Raoof, M., Näslund, I., Rask, E. & Szabo, E. (2020). Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up. Obesity Surgery, 30(12), 4995-5000
Open this publication in new window or tab >>Bone Mineral Density, Parathyroid Hormone, and Vitamin D After Gastric Bypass Surgery: a 10-Year Longitudinal Follow-Up
2020 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 30, no 12, p. 4995-5000Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The aim of the present study was to study longitudinal changes in bone mineral density (BMD), vitamin D, and parathyroid hormone (PTH) levels in females over a 10-year period after laparoscopic Roux-en-Y gastric bypass (LRYGB).

METHODS: at baseline, were included. BMD, BMI, S-calcium, S-25(OH)-vitamin D, and fP-PTH were measured preoperatively and 2, 5, and 10 years postoperatively.

RESULTS: Ten years after surgery, BMD of the spine and femoral neck decreased by 20% and 25%, respectively. Changes in serum levels of vitamin D, PTH, and calcium over the same period were small.

CONCLUSION: After LRYGB with subsequent massive weight loss, a large decrease in BMD of the spine and femoral neck was seen over a 10-year postoperative period. The fall in BMD largely occurred over the first 5 years after surgery.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
BMI, Bone health, Bone mineral density, Gastric bypass, Obesity, Parathyroid hormone, Vitamin D
National Category
Orthopaedics
Identifiers
urn:nbn:se:oru:diva-85323 (URN)10.1007/s11695-020-04912-7 (DOI)000563598800001 ()32860128 (PubMedID)2-s2.0-85089973154 (Scopus ID)
Note

Funding Agencies:

Örebro University  

Lisa & Johan Grönbergs stiftelse, Stockholm  

Available from: 2020-09-08 Created: 2020-09-08 Last updated: 2023-12-08Bibliographically approved
Stenberg, E., Rask, E., Szabo, E., Näslund, I. & Ottosson, J. (2020). The Effect of Laparoscopic Gastric Bypass Surgery on Insulin Resistance and Glycosylated Hemoglobin A1c: a 2-Year Follow-up Study. Obesity Surgery, 30(9), 3489-3495
Open this publication in new window or tab >>The Effect of Laparoscopic Gastric Bypass Surgery on Insulin Resistance and Glycosylated Hemoglobin A1c: a 2-Year Follow-up Study
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2020 (English)In: Obesity Surgery, ISSN 0960-8923, E-ISSN 1708-0428, Vol. 30, no 9, p. 3489-3495Article in journal (Refereed) Published
Abstract [en]

Background: Bariatric surgery improves insulin sensitivity and secretion in patients with type 2 diabetes, but the effect on patients with prediabetes or even normal glucose tolerance deserves further consideration.

Methods: Cohort study including patients operated with laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) between November 2012 and June 2017 at the orebro University Hospital (n = 813) with follow-up of 742 patients 2 years after surgery. Fasting insulin, glucose, glycosylated hemoglobin (HbA1c), and homeostatic model assessment of insulin resistance (HOMA-IR) were analyzed at baseline and 2 years after surgery for patients with overt type 2 diabetes, prediabetes, or non-diabetes.

Results: Fasting insulin levels improved for all groups (diabetics baseline 25.5 mIU/L, IQR 17.5-38.0, 2 years 7.6 mIU/L, IQR 5.4-11.1, p < 0.001; prediabetics baseline 25.0 mIU/L, IQR 17.5-35.0, 2 years 6.7mIU/L, IQR 5.3-8.8, p < 0.001; non-diabetics baseline 20.0 mIU/L, IQR 14.0-30.0, 2 years 6.4 mIU/L, IQR 5.0-8.5, p < 0.001). HbA1c improved in all groups (diabetics baseline 56 mmol/mol, IQR 49-74 [7.3%, IQP 6.6-8.9], 2 years 38 mmol/mol, IQR 36-47 [5.6%, IQR 5.4-6.4], p < 0.001; prediabetics baseline 40 mmol/mol, IQR 39-42 [5.8%, IQR5.7-6.0], 2 years 36 mmol/mol, IQR 34-38 [5.5%, IQR 5.3-5.6], p < 0.001; non-diabetics baseline 35 mmol/mol, IQR 33-37 [5.4%, IQR 5.2-5.5]; 2 years 34 mmol/mol, IQR 31-36 [5.3%, IQR 5.0-5.4], p < 0.001). HOMA-IR improved in all groups (diabetics baseline 9.3 mmol/mol, IQR 5.4-12.9, 2 years 1.9 mmol/mol, IQR 1.4-2.7, p < 0.001; prediabetics baseline 7.0 mmol/mol, IQR 4.3-9.9, 2 years 1.6 mmol/mol, IQR 1.2-2.1, p < 0.001; non-diabetics 4.9 mmol/mol, IQR 3.4-7.3, 2 years 1.4 mmol/mol, IQR 1.1-1.9, p < 0.001).

Conclusion: Insulin homeostasis and glucometabolic control improve in all patients after LRYGB, not only in diabetics but also in prediabetics and non-diabetic obese patients, and this improvement is sustained 2 years after surgery.

Place, publisher, year, edition, pages
Springer, 2020
Keywords
Insulin, Insulin resistance, Gastric bypass, Bariatric surgery, Postoperative outcome
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-81568 (URN)10.1007/s11695-020-04599-w (DOI)000527899000006 ()32314253 (PubMedID)2-s2.0-85084080736 (Scopus ID)
Note

Funding Agencies:

Örebro University  

Örebro County Council  

Bengt Ihre Foundation 

Available from: 2020-05-06 Created: 2020-05-06 Last updated: 2020-12-01Bibliographically approved
Rask, E., Peters, H. & Jansson, S. P. O. (2019). Hypoglykemi: problematisk komplikation av överviktskirurgi [Hypoglycemia following gastric bypass surgery: A case, causes and coping]. Läkartidningen, 116(8), Article ID 363.
Open this publication in new window or tab >>Hypoglykemi: problematisk komplikation av överviktskirurgi [Hypoglycemia following gastric bypass surgery: A case, causes and coping]
2019 (Swedish)In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 116, no 8, article id 363Article in journal (Refereed) Published
Abstract [en]

Bariatric surgery is a well-documented and good alternative for treatment of obesity with and without type 2-diabetes. One of the documented complications is postprandial hypoglycemia, with possibly serious consequences. We present such a case, what is known of underlying mechanisms, and treatment options. © 2019, Swedish Medical Association. All rights reserved.

Place, publisher, year, edition, pages
Läkartidningen Förlag AB, 2019
National Category
Surgery
Identifiers
urn:nbn:se:oru:diva-73731 (URN)2-s2.0-85062846415 (Scopus ID)
Available from: 2019-04-15 Created: 2019-04-15 Last updated: 2024-03-04Bibliographically approved
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