Quality of life after gastric bypass surgery in patients with type 2 diabetes: patients' experiences during 2 years of follow-up

Petros Katsogiannos, Eva Randell, Magnus Sundbom, Andreas Rosenblad, Jan W Eriksson, Janeth Leksell, Petros Katsogiannos, Eva Randell, Magnus Sundbom, Andreas Rosenblad, Jan W Eriksson, Janeth Leksell

Abstract

Background: To examine the effects of gastric bypass surgery on health-related quality of life (HRQoL) in obese patients with type 2 diabetes, and to investigate their experiences of life adjustments using quantitative and qualitative methods.

Methods: Thirteen patients with type 2 diabetes and obesity, (body mass index, BMI > 30 kg/m2), participating in a randomized clinical trial, completed this sub-study. HRQoL was evaluated before, and at 6 months and 2 years after gastric bypass surgery, using the RAND- 36-item health survey. At 2 years, interviews for in-depth analysis of HRQoL changes were performed.

Results: Significant improvement was observed from baseline to 6 months for 2 of the eight health concepts, general health, and emotional well-being. At 2 years, improvements were also seen in physical functioning, energy/fatigue, as well as sustained improvements in general health and emotional well-being. Multiple regression analyses showed mostly non-significant associations between the magnitude of decrease in weight, BMI, and HbA1c during follow-up and improvement in HRQoL. The analyses from qualitative interviews supported a common latent theme "Finding a balance between the experience of the new body weight and self-confidence".

Conclusions: The improved HRQoL after gastric bypass surgery in obese patients with type 2 diabetes was not explained specifically by the magnitude of weight loss, but rather by the participants achieving a state of union between body and consciousness.Trial registration ClinicalTrials.gov Identifier NCT02729246. Date of registration 6 April 2016 - Retrospectively registered https://ichgcp.net/clinical-trials-registry/NCT02729246?term=bariglykos&draw=2&rank=1.

Keywords: Quality of life; RYGB; Type 2 diabetes.

Conflict of interest statement

Competing interestsThe authors declare that they have no competing interests.

© The Author(s) 2020.

Figures

Fig. 1
Fig. 1
Results for RAND-36 domains at baseline and follow-up at 24 weeks and 2 years
Fig. 2
Fig. 2
Latent theme themes, subthemes

References

    1. Danaei G, Finucane MM, Lu Y, Singh GM, Cowan MJ, Paciorek CJ, et al. National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. Lancet. 2011;378(9785):31–40. doi: 10.1016/S0140-6736(11)60679-X.
    1. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291(3):335–342. doi: 10.1001/jama.291.3.335.
    1. Gough SC, Kragh N, Ploug UJ, Hammer M. Impact of obesity and type 2 diabetes on health-related quality of life in the general population in England. Diabetes Metab Syndr Obes. 2009;2:179–184. doi: 10.2147/DMSO.S7088.
    1. Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.e5. doi: 10.1016/j.amjmed.2008.09.041.
    1. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386(9997):964–973. doi: 10.1016/S0140-6736(15)00075-6.
    1. Colquitt JL, Pickett K, Loveman E, Frampton GK. Surgery for weight loss in adults. Cochrane Database Syst Rev. 2014;8:CD03641.
    1. Ogden J, Clementi C, Aylwin S. The impact of obesity surgery and the paradox of control: a qualitative study. Psychol Health. 2006;21(2):273–293. doi: 10.1080/14768320500129064.
    1. Griauzde DH, Ibrahim AM, Fisher N, Stricklen A, Ross R, Ghaferi AA. Understanding the psychosocial impact of weight loss following bariatric surgery: a qualitative study. BMC Obes. 2018;5:38. doi: 10.1186/s40608-018-0215-3.
    1. Cresci B, Cosentino C, Monami M, Mannucci E. Metabolic surgery for the treatment of type 2 diabetes: a network metanalysis of randomized controlled trials. Diabetes Obes Metab. 2020 doi: 10.1111/dom.14045.
    1. Szmulewicz A, Wanis KN, Gripper A, Angriman F, Hawel J, Elnahas A, et al. Mental health quality of life after bariatric surgery: A systematic review and meta-analysis of randomized clinical trials. Clin Obes. 2019;9(1):e12290. doi: 10.1111/cob.12290.
    1. Wykowski K, Krouse HJ. Self-care predictors for success post-bariatric surgery: a literature review. Gastroenterol Nurs. 2013;36(2):129–135. doi: 10.1097/SGA.0b013e3182891295.
    1. Health USDo, Human Services FDACfDE, Research, Health USDo, Human Services FDACfBE, Research et al. Guidance for industry: patient-reported outcome measures: use in medical product development to support labeling claims: draft guidance. Health Qual Life Outcomes. 2006;4:79. doi: 10.1186/1477-7525-4-79.
    1. Fisher L, Tang T, Polonsky W. Assessing quality of life in diabetes: I. a practical guide to selecting the best instruments and using them wisely. Diabetes Res Clin Pract. 2017;126:278–285. doi: 10.1016/j.diabres.2016.10.018.
    1. Speight J, Reaney MD, Barnard KD. Not all roads lead to Rome-a review of quality of life measurement in adults with diabetes. Diabet Med. 2009;26(4):315–327. doi: 10.1111/j.1464-5491.2009.02682.x.
    1. Orwelius L, Nilsson M, Nilsson E, Wenemark M, Walfridsson U, Lundstrom M, et al. The Swedish RAND-36 Health Survey - reliability and responsiveness assessed in patient populations using Svensson's method for paired ordinal data. J Patient Rep Outcomes. 2017;2(1):4. doi: 10.1186/s41687-018-0030-0.
    1. Katsogiannos P, Kamble PG, Boersma GJ, Karlsson FA, Lundkvist P, Sundbom M, et al. Early changes in adipose tissue morphology, gene expression, and metabolism after RYGB in patients with obesity and T2D. J Clin Endocrinol Metab. 2019;104(7):2601–2613. doi: 10.1210/jc.2018-02165.
    1. Katsogiannos P, Kamble PG, Wiklund U, Sundbom M, Espes D, Hammar U, et al. Rapid changes in neuroendocrine regulation may contribute to reversal of type 2 diabetes after gastric bypass surgery. Endocrine. 2020;67(2):344–353. doi: 10.1007/s12020-020-02203-w.
    1. Hays RD, Morales LS. The RAND-36 measure of health-related quality of life. Ann Med. 2001;33(5):350–357. doi: 10.3109/07853890109002089.
    1. Hopman WM, Berger C, Joseph L, Towheed T, VandenKerkhof E, Anastassiades T, et al. The natural progression of health-related quality of life: results of a five-year prospective study of SF-36 scores in a normative population. Qual Life Res. 2006;15(3):527–536. doi: 10.1007/s11136-005-2096-4.
    1. Wang HM, Beyer M, Gensichen J, Gerlach FM. Health-related quality of life among general practice patients with differing chronic diseases in Germany: cross sectional survey. BMC Public Health. 2008;8:246. doi: 10.1186/1471-2458-8-246.
    1. Krippendorff K. Content analysis: an introduction to its methodology. 3. Los Angeles: SAGE; 2013.
    1. Svedbo Engstrom M, Leksell J, Johansson UB, Borg S, Palaszewski B, Franzen S, et al. Health-related quality of life and glycaemic control among adults with type 1 and type 2 diabetes - a nationwide cross-sectional study. Health Qual Life Outcomes. 2019;17(1):141. doi: 10.1186/s12955-019-1212-z.
    1. Gryth K, Persson C, Naslund I, Sundbom M, Naslund E, Stenberg E. The influence of socioeconomic factors on quality-of-life after laparoscopic gastric bypass surgery. Obes Surg. 2019;29(11):3569–3576. doi: 10.1007/s11695-019-04028-7.
    1. Raoof M, Naslund I, Rask E, Karlsson J, Sundbom M, Edholm D, et al. Health-related quality-of-life (HRQoL) on an average of 12 years after gastric bypass surgery. Obes Surg. 2015;25(7):1119–1127. doi: 10.1007/s11695-014-1513-6.
    1. Liebl L, Barnason S, Brage HD. Awakening: a qualitative study on maintaining weight loss after bariatric surgery. J Clin Nurs. 2016;25(7–8):951–961. doi: 10.1111/jocn.13129.
    1. Eeg-Olofsson K, Johansson UB, Linder E, Leksell J. Patients' and health care professionals' perceptions of the potential of using the digital diabetes questionnaire to prepare for diabetes care meetings: qualitative focus group interview study. J Med Internet Res. 2020;22(8):e17504. doi: 10.2196/17504.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner