Bariatric surgery for type 2 diabetes
In the July 2010 edition of the
Cleveland Clinic Journal of Medicine is a clinical review titled
Bariatric surgery for type 2 diabetes: Weighing the impact for obese patients by Sangeeta R Kashyap, Patrick Gatmaitan, Stacy Brethhauer and Philip Schauer that begins:
" Obesity is a potent risk factor for the development
and progression of type 2 diabetes, and weight loss is a key
component of diabetes management. Bariatric surgery results in
significant weight loss and remission of diabetes in most
patients. After surgery, glycemic control is restored by a
combination of enforced caloric restriction, enhanced insulin
sensitivity, and increased insulin secretion.
" The reviewers make the following key points:
After Roux-en-Y gastric bypass and biliopancreatic diversion, normoglycemia is restored within days, even before the patient has lost much weight. Alterations in postprandial levels of intestine-derived hormones (glucagon-like peptide 1, peptide YY, and ghrelin) contribute to the robust metabolic benefits of intestinal bypass procedures.
Nutritional deficiencies are common after bariatric surgery, and long-term follow-up is mandatory for surveillance of metabolic status.
Although curing diabetes cannot yet be considered a goal of bariatric surgery, it may be a serendipitous benefit. "
For the full review, click here.
Cleveland Clinic Journal of Medicine 77(7):468-476 © 2010 The Cleveland Clinic Foundation
Bariatric surgery for type 2 diabetes: Weighing the impact for obese patients. Sangeeta R Kashyap, Patrick Gatmaitan, Stacy Brethhauer and Philip Schauer. Correspondence to Philip Schauer:
schauep@ccf.org Category: T. Endocrine/Metabolic/Nutritional. Keywords: bariatric surgery, type 2 diabetes, obesity, clinical review.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia Posted on Global Family Doctor 30 July 2010
