Bariatric Surgery for Adolescents with Type 2 Diabetes: an Emerging Therapeutic Strategy
Purpose of Review
Type 2 diabetes (T2D) is a growing public health problem in youth, but conventional treatments are often insufficient to treat this disease and its comorbidities. We review evidence supporting an emerging role for bariatric surgery as a treatment for adolescent T2D.
Paralleling what has been seen in adult patients, bariatric surgery dramatically improves glycemic control in patients with T2D. In fact, remission of T2D has been observed in as many as 95–100% of adolescents with diabetes after bariatric surgery, particularly vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) surgery. This striking outcome may be due to both weight-dependent- and weight-independent factors, and recent studies suggest that T2D-related comorbidities may also improve after surgery.
Bariatric surgery including RYGB and VSG is a powerful therapeutic option for obese adolescents with T2D. Benefits must be weighed against risk for postoperative complications such as nutritional deficiencies, but earlier surgical intervention might lead to more complete metabolic remission in obese patients with T2D.
KeywordsBariatric surgery Type 2 diabetes Obesity Adolescent Roux-en-Y gastric bypass surgery Sleeve gastrectomy
Dr. Stefater has received research grants from the Pediatric Endocrine Society and the Endocrine Fellows Foundation. Her training is also funded by an institutional T32 (DK007699) training grant.
Dr. Inge has received grants from the National Institute of Diabetes and Digestive and Kidney Diseases.
Compliance with Ethical Standards
Conflict of Interest
Dr. Stefater declares that she has no conflict of interest.
Dr. Inge has been a consultant for Standard Bariatric and UpToDate.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human participants or animals performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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