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- Haenni, Arvo, et al.
(författare)
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Circulating magnesium status is associated with type 2 diabetes remission after Roux-en-Y gastric bypass surgery : a long-term cohort study
- 2021
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 17:2, s. 299-307
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Low serum magnesium levels predict cardiovascular and all-cause mortality in patients with typ 2 diabetes.SETTING: Outpatient clinic of obesity and central hospital.OBJECTIVES: To assess long-term alterations in circulating magnesium status after Roux-en-Y gastric bypass (RYGB) surgery and associations with remission of type 2 diabetes (T2D).METHODS: Retrospective analysis of 5-year outcomes of plasma magnesium (p-Mg) and glucometabolic statuses in patients who underwent primary RYGB and who completed the annual follow-up program. Data were investigated from 84 patients without diabetes and 62 with T2D before RYGB, who showed either prolonged remission (n = 30), temporary remission (n = 16), or no remission (n = 16) after surgery.RESULTS: Body mass indexes before RYGB were similar in patients with and without T2D, irrespective of remission. The patients not achieving remission showed longer diabetes durations; higher circulating glucose levels; more intensive antidiabetic drug treatment, including insulin; and significantly lower p-Mg concentrations (.73 [±.08] mmol/L compared with .80-.82 [±.07] mmol/L, respectively; P < .01) than the groups showing remission or without diabetes before surgery. After RYGB, the p-Mg increased similarly, by 10-12% in the groups with T2D before surgery, irrespective of remission; however, the nonremission group did not reach the p-Mg levels registered in the other groups after follow-up. The nonremission group reached .82 (.09) mmol/L, compared with .87 (.06) and .88 (.08) mmol/L (P < .05), respectively, in patients with remission or without a history of diabetes.CONCLUSION: The p-Mg concentrations increased after RYGB, with similar increments irrespective of T2D remission; however, the nonremission group started from an inferior level and did not reach the p-Mg concentrations seen in the groups achieving remission or without a history of diabetes before surgery.
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- Holmen, Heidi, et al.
(författare)
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Unpacking the Public Health Triad of Social Inequality in Health, Health Literacy, and Quality of Life-A Scoping Review of Research Characteristics
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - : Journal Issues. - 1661-7827 .- 1660-4601. ; 21:1
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Forskningsöversikt (refereegranskat)abstract
- Social inequalities in health, health literacy, and quality of life serve as distinct public health indicators, but it remains unclear how and to what extent they are applied and combined in the literature. Thus, the characteristics of the research have yet to be established, and we aim to identify and describe the characteristics of research that intersects social inequality in health, health literacy, and quality of life. We conducted a scoping review with systematic searches in ten databases. Studies applying any design in any population were eligible if social inequality in health, health literacy, and quality of life were combined. Citations were independently screened using Covidence. The search yielded 4111 citations, with 73 eligible reports. The reviewed research was mostly quantitative and aimed at patient populations in a community setting, with a scarcity of reports specifically defining and assessing social inequality in health, health literacy, and quality of life, and with only 2/73 citations providing a definition for all three. The published research combining social inequality in health, health literacy, and quality of life is heterogeneous regarding research designs, populations, contexts, and geography, where social inequality appears as a contextualizing variable.
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3. |
- Hänni, Arvo, et al.
(författare)
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Increased circulating magnesium concentrations after Roux-en-Y gastric bypass surgery in patients with type 2 diabetes
- 2018
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 14:5, s. 576-582
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Tidskriftsartikel (refereegranskat)abstract
- Background: Low circulating magnesium concentrations predict cardiovascular and all-cause mortality in patients with type 2 diabetes (T2D). Epidemiologic and clinical studies have indicated lower extra- and intracellular magnesium concentrations in patients with diabetes.Objective: We aimed to describe alterations, if any, in circulating magnesium concentrations after laparoscopic Roux-en-Y gastric bypass surgery (LRYGB) in patients with obesity and T2D.Setting: Outpatient clinic of obesity and central hospital.Methods: Retrospective analysis of 1-year outcome of plasma magnesium (p-Mg) and glucometabolic status in all consecutive patients who underwent primary LRYGBP and who completed the follow-up visits, including biochemical test panels 6 and 12 months after surgery.Results: LRYGBP and complete follow-up visits were performed in 51 patients with T2D and 86 patients without T2D. All patients were given similar dietary advice and multivitamin and mineral supplementation after surgery. Before RYGB, the patients with T2D showed lower p-Mg compared with patients without T2D (.79 ± .06 mM and .82 ± .05 mM, respectively, P<.01). P-Mg was inversely correlated to fasting blood glucose and glycosylated hemoglobin levels. After surgery, mean p-Mg increased by 5.2% in the group with T2D compared with 1.4% in the patients without T2D (P<.01), ending at an equal level of .83 mM. The alterations in p-Mg were inversely related to the changes in fasting glucose and glycosylated hemoglobin concentrations.Conclusion: The lowered p-Mg associated with impaired glucometabolic status in patients with T2D was increased after LRYGBP, reaching similar concentrations as in patients without T2D.
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5. |
- Jawak, Shridhar D., et al.
(författare)
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SIOS's Earth Observation (EO), Remote Sensing (RS), and Operational Activities in Response to COVID-19
- 2021
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Ingår i: Remote Sensing. - : MDPI. - 2072-4292. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- Svalbard Integrated Arctic Earth Observing System (SIOS) is an international partnership of research institutions studying the environment and climate in and around Svalbard. SIOS is developing an efficient observing system, where researchers share technology, experience, and data, work together to close knowledge gaps, and decrease the environmental footprint of science. SIOS maintains and facilitates various scientific activities such as the State of the Environmental Science in Svalbard (SESS) report, international access to research infrastructure in Svalbard, Earth observation and remote sensing services, training courses for the Arctic science community, and open access to data. This perspective paper highlights the activities of SIOS Knowledge Centre, the central hub of SIOS, and the SIOS Remote Sensing Working Group (RSWG) in response to the unprecedented situation imposed by the global pandemic coronavirus (SARS-CoV-2) disease 2019 (COVID-19). The pandemic has affected Svalbard research in several ways. When Norway declared a nationwide lockdown to decrease the rate of spread of the COVID-19 in the community, even more strict measures were taken to protect the Svalbard community from the potential spread of the disease. Due to the lockdown, travel restrictions, and quarantine regulations declared by many nations, most physical meetings, training courses, conferences, and workshops worldwide were cancelled by the first week of March 2020. The resumption of physical scientific meetings is still uncertain in the foreseeable future. Additionally, field campaigns to polar regions, including Svalbard, were and remain severely affected. In response to this changing situation, SIOS initiated several operational activities suitable to mitigate the new challenges resulting from the pandemic. This article provides an extensive overview of SIOS's Earth observation (EO), remote sensing (RS) and other operational activities strengthened and developed in response to COVID-19 to support the Svalbard scientific community in times of cancelled/postponed field campaigns in Svalbard. These include (1) an initiative to patch up field data (in situ) with RS observations, (2) a logistics sharing notice board for effective coordinating field activities in the pandemic times, (3) a monthly webinar series and panel discussion on EO talks, (4) an online conference on EO and RS, (5) the SIOS's special issue in the Remote Sensing (MDPI) journal, (6) the conversion of a terrestrial remote sensing training course into an online edition, and (7) the announcement of opportunity (AO) in airborne remote sensing for filling the data gaps using aerial imagery and hyperspectral data. As SIOS is a consortium of 24 research institutions from 9 nations, this paper also presents an extensive overview of the activities from a few research institutes in pandemic times and highlights our upcoming activities for the next year 2021. Finally, we provide a critical perspective on our overall response, possible broader impacts, relevance to other observing systems, and future directions. We hope that our practical services, experiences, and activities implemented in these difficult times will motivate other similar monitoring programs and observing systems when responding to future challenging situations. With a broad scientific audience in mind, we present our perspective paper on activities in Svalbard as a case study.
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6. |
- Nilsen, Inger, et al.
(författare)
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Comparison of Meal Pattern and Postprandial Glucose Response in Duodenal Switch and Gastric Bypass Patients
- 2019
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Ingår i: Obesity Surgery. - : SPRINGER. - 0960-8923 .- 1708-0428. ; 29:7, s. 2210-2216
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Tidskriftsartikel (refereegranskat)abstract
- Background: Bariatric surgery improves glucose homeostasis; however, side effects such as hypoglycemia can occur. We investigated the effects of meals on interstitial glucose (IG) response in biliopancreatic diversion with duodenal switch (BPD-DS) and Roux-en-Y gastric bypass (RYGBP)-operated patients at least 1 year after surgery.Methods: Thirty patients treated with BPD-DS or RYGBP were recruited at the outpatient Obesity Unit, Uppsala University Hospital. IG was measured by continuous glucose monitoring (CGM) for 3 consecutive days, and postprandial IG levels from 5 to 120 min were analyzed for 2 of these days. All intake of food and beverages was simultaneously registered in a food diary, which was processed using The Meal Pattern Questionnaire.Results: Postprandial IG levels were significantly lower in BPD-DS (n = 14) compared to RYGBP (n = 15)-treated patients, with mean concentrations of 5.0 (+/- 1.0) and 6.3 (+/- 1.8) mmol/L respectively (p < 0.001). The mean postprandial IG increment was lower in BPD-DS than in RYGBP patients, 0.2 (+/- 0.6) vs. 0.4 (+/- 1.4) mmol/L (p < 0.001). Furthermore, the postprandial IG variability was less pronounced in BPD-DS than in RYGBP patients. The mean number of daily meals did not differ between the two groups, 7.8 (+/- 2.6) in BPD-DS and 7.2 (+/- 1.7) in the RYGBP (p = 0.56).Conclusion: BPD-DS patients demonstrated lower postprandial IG concentrations, with smaller postprandial IG increments and less pronounced postprandial IG variability compared to RYGBP patients. The two groups had similar meal pattern and the postprandial IG responses is probably associated with differences in postoperative physiology.
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7. |
- Nilsen, Inger, Cand. Scient, 1968-, et al.
(författare)
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Glycemic variability and hypoglycemia before and after Roux-en-Y Gastric Bypass and Sleeve Gastrectomy : A cohort study of females without diabetes
- 2024
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Ingår i: Surgery for Obesity and Related Diseases. - : Elsevier. - 1550-7289 .- 1878-7533. ; 20:1, s. 10-16
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) lead to lower fasting glucose concentrations, but might cause higher glycemic variability (GV) and increased risk of hypoglycemia. However, it has been sparsely studied in patients without preoperative diabetes under normal living conditions.OBJECTIVES: To study 24-hour interstitial glucose (IG) concentrations, GV, the occurrence of hypoglycemia and dietary intake before and after laparoscopic RYGB and SG in females without diabetes.SETTING: Outpatient bariatric units at a community and a university hospital.METHODS: Continuous glucose monitoring and open-ended food recording over 4 days in 4 study periods: at baseline, during the preoperative low-energy diet (LED) regimen, and at 6 and 12 months postoperatively.RESULTS: Of 47 patients included at baseline, 83%, 81%, and 79% completed the remaining 3 study periods. The mean 24-hour IG concentration was similar during the preoperative LED regimen and after surgery and significantly lower compared to baseline in both surgical groups. GV was significantly increased 6 and 12 months after surgery compared to baseline. The self-reported carbohydrate intake was positively associated with GV after surgery. IG concentrations below 3.9 mmol/L were observed in 14/25 (56%) of RYGB- and 9/12 (75%) of SG-treated patients 12 months after surgery. About 70% of patients with low IG concentrations also reported hypoglycemic symptoms.CONCLUSIONS: The lower IG concentration in combination with the higher GV after surgery, might create a lower margin to hypoglycemia. This could help explain the increased occurrence of hypoglycemic episodes after RYGB and SG.
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8. |
- Nilsen, Inger, 1968-, et al.
(författare)
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Lower Interstitial Glucose Concentrations but Higher Glucose Variability during Low-Energy Diet Compared to Regular Diet-An Observational Study in Females with Obesity
- 2021
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Ingår i: Nutrients. - : MDPI AG. - 2072-6643. ; 13:11
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Tidskriftsartikel (refereegranskat)abstract
- This is an observational study of interstitial glucose (IG) concentrations, IG variability and dietary intake under free-living conditions in 46 females with obesity but without diabetes. We used continuous glucose monitoring, open-ended food recording and step monitoring during regular dietary intake followed by a low-energy diet (LED). Thirty-nine participants completed both study periods. The mean BMI at baseline was 43.6 & PLUSMN; 6.2 kg/m(2). Three weeks of LED resulted in a mean weight loss of 5.2% with a significant reduction in diurnal IG concentration but with greater glycemic variability observed during LED. The mean 24 h IG concentration decreased from 5.8 & PLUSMN; 0.5 mmol/L during the regular diet period to 5.4 & PLUSMN; 0.5 mmol/L (p < 0.001) during LED, while the mean amplitude of glycemic excursion increased from 1.5 & PLUSMN; 0.7 to 1.7 & PLUSMN; 0.7 mmol/L (p = 0.031). The positive incremental area under the curve at breakfast was significantly larger for LED compared to regular diet. The daily fiber intake and the glycemic index of breakfast meals were significantly associated with the glycemic variability during regular dietary intake. In conclusion, the 24 h mean IG concentration was lower but with more pronounced glycemic variability during LED compared to a regular diet.
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