Background: Roux-en-Y gastric bypass surgery is widely applied to ameliorate morbid obesity, including diabetes\nin people with type 2 diabetes. The latter vanish a few days after surgery for many, but not in all patients before\nany weight reduction has occurred. The explanation for this change in metabolic status is poorly understood, but\nthe observation may suggest that the fate obesity and diabetes is only partly linked after surgery.\nMethods: The trajectories of weight reduction measured as reduced body mass index (BMI) in 741obese subjects\nwith and without diabetes were evaluated. Evaluation was performed on three groups: 1) subjects that were\nnon-diabetic before and after surgery; 2) subjects that were diabetics before surgery but non-diabetics after\nsurgery; and 3) subjects that were diabetics before surgery and remained diabetics after surgery. The diabetic\nstate was established at HbA1c above 48 mmol/mol.\nResults: The trajectories differ significantly between groups and any sub-populations of groups, the latter identified by\nthe distance between individual trajectories using a k-means procedure. The results suggest that different domains in\nthe enormous genetic network governing basic metabolism are perturbed in obesity and diabetes, and in fact some of\nthe patients are affected by two distinct diseases: obesity and diabetes mellitus type 2.\nConclusion: Although RYGB ââ?¬Å?normalizedââ?¬Â many glycaemic parameters in some of the diabetic subjects apparently\nconverting to a non-diabetics state, other diabetic subjects stay diabetic in the context of the new gut anatomy after\nsurgery. Thus, the obesity part of the glycaemic derangement may have been ameliorated, but some defects of the\ndiabetic state had not.
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