Role of Bariatric Surgery in Diabetes
- 620 Downloads
Obesity and diabetes are chronic diseases frequently linked together. Durable weight loss is uncommon with medical/behavioral approaches. For severe obesity, bariatric surgery is the only treatment resulting in sustained weight loss. Bariatric surgery may be considered for adults with BMI ≥ 35 kg/m2 and type 2 diabetes, especially if the diabetes or associated comorbidities are difficult to control with lifestyle and pharmacological therapy. Bariatric surgery reduces the incidence of diabetes in overweight insulin-resistant subjects and is associated with remission of diabetes in a large proportion of patients. In considering the usefulness of bariatric surgery, it is also important to recognize that long-term follow-up is required before assigning a beneficial therapeutic effect in patients with diabetes because of the potential for weight regain that has been observed. As diabetes is a lifelong disease, it is important to emphasize that a certain percentage of patients will suffer from relapse of their diabetes.
KeywordsType 2 diabetes Obesity Weight loss Bariatric surgery Non-surgical duodenal exclusion Diabetes remission
Paul Poirier has received grant support from the Canadian Institute Health Research (CHIR). Audrey Auclair is recipient of a studentship from the Canadian Institute of Health Research.
Compliance with Ethics Guidelines
Conflict of Interest
Paul Poirier and Audrey Auclair declares that he has no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
- 3.Despres JP, Poirier P. Diabetes: Looking back at Look AHEAD-giving lifestyle a chance. Nat Rev Cardiol 2013.Google Scholar
- 4.Wing RR, Bolin P, Brancati FL, Bray GA, Clark JM, Coday M, et al. Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes. N Engl J Med. 2013;369(2):145–54.Google Scholar
- 5.••Poirier P, Cornier MA, Mazzone T, et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation. 2011;123:1683–701. American Heart Association scientific statement regarding bariatric surgery and management of cardiovascular risk factors.PubMedCrossRefGoogle Scholar
- 10.Standards of medical care in diabetes--2013. Diabetes Care 2013;36 Suppl 1:S11-S66.Google Scholar
- 12.••Rubino F, Kaplan LM, Schauer PR, Cummings DE. The Diabetes Surgery Summit consensus conference: recommendations for the evaluation and use of gastrointestinal surgery to treat type 2 diabetes mellitus. Ann Surg. 2010;251:399–405. Consensus from expert in the field of bariatric surgery regarding bariatric surgeryin the management of patient with type 2 diabetes.PubMedCrossRefGoogle Scholar
- 15.Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev 2009;CD003641.Google Scholar
- 19.••Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366:1567–76. A landmark randomized controlled trials comparing RYGB and sleeve gastrectomy with medical therapy to treat type 2 diabetes.PubMedCentralPubMedCrossRefGoogle Scholar