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Metabolic Surgery for Type 2 Diabetes: Appraisal of Clinical Evidence and Review of Randomized Controlled Clinical Trials Comparing Surgery with Medical Therapy

  • Harold E. LebovitzEmail author
Lipid and Metabolic Effects of Gastrointestinal Surgery (F Rubino, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lipid and Metabolic Effects of Gastrointestinal Surgery

Abstract

Bariatric surgical procedures were originally developed to treat morbid obesity where their benefits certainly outweigh their potential side effects. Although they are very beneficial in improving metabolic control in type 2 diabetes, there are many medical treatments that are also effective. The role of bariatric surgery as primary therapy for type 2 diabetes depends on whether the benefit exceeds the surgical and nutritional complications, which are significant. The ultimate role for bariatric surgery in treating type 2 diabetes can only be determined by large, long-term randomized clinical trials which compare clinical outcomes of bariatric surgery with those of current intensive medical treatment. The four reported small, mostly 1-year trials have shown superior glycemic control by surgery as compared with medical treatment, but at the expense of significant surgical complications and unknown nutritional liability. They show that future trials will have to be much larger and last for at least 5–10 years.

Keywords

Bariatric surgery Type 2 diabetes Metabolic control Mortality Surgical complications Nutritional disturbances Randomized clinical trials Medical therapy 

Notes

Conflict of Interest

Harold E. Lebovitz is a scientific advisory board member of Biocon, Amylin Pharma, Intarcia Pharma, Janssen Pharmaceuticals, Metacure, and Poxel Pharma. He has received payment for the development of educational material for AstraZenica and Bristol Myers Squibb. He owns stock shares in Abbott, Abbvie and Merck.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.State University of New York Health Science Center at BrooklynBrooklynUSA

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