Introduction: Roux-en-Y gastric bypass (RYGB) leads to durable type 2 diabetes (DM2) remission. Increased glucagon-like peptide-1 (GLP-1) levels and caloric restriction are known sequela of RYGB and independently improve DM2 control.

Hypothesis: Since Liraglutide increases GLP-1 levels and the OPTIFAST program induces caloric restriction, we hypothesize that Liraglutide + OPTIFAST will medically reproduce RYGB and lead to DM2 remission, weight loss, decreased medication intensity and improved health related quality of life (HRQL).

Methods: The Medically Reproducing Bariatric surgery (MRB) study is a pilot study that tested whether poorly controlled DM2 subjects on Liraglutide ± other diabetic medicines experienced DM2 remission after completing the 24 week OPTIFAST program. Primary outcome: glycemic control. Secondary outcome: weight, medication intensity and HRQL measured by Problem Areas In Diabetes (PAID) score.

Results:

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Conclusion: Responders (yellow) vis-a-vis Non-responders (plain) experienced significant improvements in glycemic control, weight, medication intensity and HRQL. Responders vis-a-vis Non-responders had much better compliance during the OPTIFAST weight loss phase (week 1-12) when 800 calories per day were being consumed. Non-responders still experienced modest improvement in weight loss and HRQL. No serious adverse events occurred. The MRB approach merits further study.

Disclosure

M. Dar: None. K.F. Smythe: None. N.K. Leggett-Frazier: None. W.S. Yancy: None.

Funding

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© 2019 by the American Diabetes Association.
2019
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