Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Claus Bogh Juhl, University of Southern Denmark and University Hospital of Southern Denmark
- Second opponent: Senior Consultant Torunn Kristin Nestvold, Nordland Hospital
- Third member and chair of the evaluation committee: Associate Professor Elisabeth Qvigstad, University of Oslo
Chair of the Defence
Associate Professor Anne-Marie Aas, University of Oslo
Principal Supervisor
Senior Consultant Dag Hofsø, Vestfold Hospital Trust
Summary
The current international guidelines for bariatric surgery in patients with morbid obesity and type 2 diabetes mellitus do not discriminate between sleeve gastrectomy and gastric bypass, which are the two most common bariatric procedures worldwide. In this thesis, which is based on the triple-blind randomized controlled Oseberg study, these two surgical procedures were compared for type 2 diabetes mellitus remission and their effects on pancreatic beta cell function using intravenous and oral glucose tolerance tests. A significantly greater proportion of patients experienced type 2 diabetes remission after gastric bypass than after sleeve gastrectomy at one year (75 % versus 48 %). Moreover, both weight loss and incretin mediated beta cell function were significantly greater after gastric bypass than after sleeve gastrectomy, and mediated remission of type 2 diabetes. These findings challenge the common view that the two surgical procedures yield similar results and give insight into the mechanisms explaining these differences. Complications and side-effects were similar between the two groups. The randomized controlled design and the use of valid methods for the assessment of insulin secretion make our results reliable. The preferential use of gastric bypass as the bariatric procedure for patients with obesity and type 2 diabetes thus has the potential to improve patient care, change clinical guidelines and practice and reduce the associated societal costs.
Additional information
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