IMMUNOLOGICAL EVALUATION OF PATIENTS WITH TYPE 2 DIABETES MELLITUS SUBMITTED TO METABOLIC SURGERY

Area of Science:

• Metabolic Surgery
• Immunology
• Endocrinology

Background:

• Inflammation and immunological factors are crucial in type 2 diabetes mellitus (T2DM) development and progression.
• Understanding these mechanisms is key to developing effective T2DM treatments.

Purpose of the Study:

• To investigate changes in immunological parameters following duodenojejunal bypass surgery with ileal interposition (DJBII) in T2DM patients.
• To assess the impact of DJBII on insulin metabolism and betacell function.

Main Methods:

• Seventeen T2DM patients underwent DJBII surgery.
• Serum cytokine profiles (pro-inflammatory: IFN-γ, TNF-α, IL-17A; anti-inflammatory: IL-4, IL-10) were analyzed pre- and post-surgery.
• Anthropometric measures, glucose levels, and insulin use were also evaluated.

Main Results:

• No significant changes in pro-inflammatory cytokine expression were observed.
• A significant decrease in anti-inflammatory IL-10 expression correlated with reduced insulin dose, glycemic index, and BMI.
• Weight loss, diabetes remission, and improved metabolic syndrome control were noted, potentially due to incretin production (GLP-1, PYY).

Conclusions:

• Postoperative low-grade inflammation was associated with improved glycemic control and absence of obesity.
• DJBII surgery positively influences immunological parameters and metabolic health in T2DM patients.
• These findings support DJBII as a beneficial surgical approach for managing T2DM and associated metabolic conditions.