To Örebro University

Bariatric surgery, these days commonly implemented with Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG), is an effective way for patients with obesityto lose weight. In patients with obesity and concomitant type 2 diabetes mellitus (T2D), it has been observed that a significant proportion achieve remission of their diabetes after bariatric surgery. Bariatric surgery usually causes food to reach the intestine more quickly, which can cause unpleasant symptoms (dumping) and in some cases causes post-bariatric hypoglycemia (PBH).

Study I aimed to analyze how the duration of diabetes before surgery affects the chance of diabetes remission. There was a clear association, in which short diabetes duration and less severe diabetes before surgery entailed an improved chance of remission.

The primary goal of Study II was to study the factors that can predict late relapse of diabetes in patients who initially achieve diabetes remission after obesity surgery. It was concluded that longer diabetes duration, higher preoperative HbA1c value, less postoperative weight loss, female sex, and insulin treatment before surgery increase the risk of relapse of diabetes after initial remission.

In Study III, the English-language Dumping Severity Scale (DSS) questionnaire was translated into Swedish (DSS-Swe). The DSS-Swe questionnaire was then reliability tested for Swedish conditions. The questionnaire rates eight symptoms associated with dumping and six symptoms associated with hypoglycemia. The DSS-Swe was considered to have good reliability regarding both internal consistency and test-retest performance for use in Swedish populations.

The aim of Study IV was to study the prevalence of dumping and PBH symptoms at different time points before and after bariatric surgery using the DSS-Swe questionnaire. The conclusion was that symptoms of dumping and PBH were common after RYGB, while no significant increase was observed after SG.