Bariatric/metabolic surgery: the diabetologist’s view
Authors:
M. Haluzík 1,2,3
Authors‘ workplace:
Centrum experimentální medicíny a Centrum diabetologie, Institut klinické a experimentální medicíny, Praha
1; Ústav lékařské biochemie a laboratorní diagnostiky 1. lékařské fakulty Univerzity Karlovy a Všeobecné fakultní nemocnice Praha
2; Endokrinologický ústav, Praha
3
Published in:
Rozhl. Chir., 2019, roč. 98, č. 2, s. 46-51.
Category:
Review
Overview
Bariatric surgery is a traditional method used for the treatment of higher degrees of obesity. Emerging evidence suggests that it also represents a very efficacious approach to the treatment of metabolic complications of obesity, in particular type 2 diabetes mellitus. In this paper, we summarize the results of the studies exploring the influence of bariatric surgery on the metabolic complications of obesity and discuss possible mechanism behind the improvements or remission of diabetes after bariatric surgery. We also discuss the results of recently published studies directly comparing the efficacy of bariatric surgery and intensive pharmacological treatment of diabetes. New consensus concerning the position of bariatric surgery in the treatment algorithm of type 2 diabetes is also covered in detail along with practical aspects of the preparation of patients for bariatric surgery and their long-term follow-up after the operation.
Keywords:
obesity – bariatric surgery – diabetes remission
Sources
1. Rubino F, Cummings DE: Surgery: the coming of age of metabolic surgery. Nat Rev Endocrinol 2012;8:702−4.
2. Saverio Papadia F, Nannipieri M, Konrad Karcz W, et al. Metabolic effects of bariatric surgery. J Obes 2011. Available from:doi: [10.1155/2011/838934]
3. Dixon JB, le Roux CW, Rubino F, et al. Bariatric surgery for type 2 diabetes. Lancet 2012,379:2300−11.
4. Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741–752.
5. Pournaras DJ, Osborne A, Hawkins SC, et al. Remission of type 2 diabetes after gastric bypass and banding: mechanisms and 2 year outcomes. Ann Surg 2010;252:966−71.
6. Schauer PR, Bhatt DL, Kirwan JP, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med 201;370:2002−13.
7. Ooi GJ, Doyle L, Tie T, et al. Weight loss after laparoscopic adjustable gastric band and resolution of the metabolic syndrome and its components. Int J Obes (Lond) 2017;41:902−8.
8. Nannipieri M, Baldi S, Mari A, et al. Roux-en-Y gastric bypass and sleeve gastrectomy: Mechanisms of diabetes remission and role of gut hormones. J Clin Endocrinol Metab 2013.
9. Shi X, Karmali S, Sharma AM, et al. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 2010;20:1171−7.
10. Laurenius A, Taha O, Maleckas A, et al. Laparoscopic biliopancreatic diversion/duodenal switch or laparoscopic Roux-en-Y gastric bypass for super-obesity-weight loss versus side effects. Surg Obes Relat Dis 2010;6:408−4.
11. Haluzik M, Kratochvilova H, Haluzikova D, et al. Gut as an emerging organ for the treatment of diabetes: focus on mechanism of action of bariatric and endoscopic interventions. J Endocrinol 2018;237:R1−R17.
12. Vitek L, Haluzik M. The role of bile acids in the metabolic regulations. Endocrinol 2016;228:R85−96.
13. Rubino F, Forgione A, Cummings DE, et al. The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes. Ann Surg 2006;244:741−9.
14. Rubino F, Marescaux J. Effect of duodenal-jejunal exclusion in a non-obese animal model of type 2 diabetes: a new perspective for an old disease. Ann Surg 2004;239:1−11.
15. de Jonge C, Rensen SS, Verdam FJ, et al. Impact of duodenal-jejunal exclusion on satiety hormones. Obes Surg 2015.
16. Fried M, Yumuk V, Oppert JM, et al. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg 2014;24:42−55.
17. Hanipah ZN, Schauer PR. Surgical treatment of obesity and diabetes. Gastrointest Endosc Clin N Am 2017;27:191−211.
18. O‘Brien PE. Bariatric surgery: mechanisms, indications and outcomes. J Gastroenterol Hepatol 201;25:1358−65.
19. Bal BS, Finelli FC, Koch TR. Origins of and recognition of micronutrient deficiencies after gastric bypass surgery. Curr Diab Rep 2011;11:136−41.
20. Ashrafian H, Bueter M, Ahmed K, et al. Metabolic surgery: an evolution throughbariatric animal models. Obes Rev 2010;11:907−20.
21. Cummings DE. Endocrine mechanisms mediating remission of diabetes after gastric bypass surgery. Int J Obes (Lond) 2009, 33 Suppl 1:S33−40.
22. Myronovych A, Kirby M, Ryan KK, et al. Vertical sleeve gastrectomy reduces hepatic steatosis while increasing serum bile acids in a weight-loss-independent manner. Obesity (Silver Spring) 2014;22:390−400.
23. Abdelbaki TN, Huang CK, Ramos A, et al. Gastric plication for morbid obesity: a systematic review. Obes Surg 2012;22:1633−9.
24. Pories WJ. Bariatric surgery: risks and rewards. J Clin Endocrinol Metab 2008;93:S89−S96.
25. Welbourn R, Pournaras D. Bariatric surgery: a cost-effective intervention for morbid obesity; functional and nutritional outcomes. Proc Nutr Soc 2010;69:528−35.
26. Benedetti G, Mingrone G, Marcoccia S, et al. Body composition and energy expenditure after weight loss following bariatric surgery. J Am Coll Nutr 2000;19:270−4.
27. Rubino F, Nathan DM, Eckel RH, et al. Metabolic surgery in the treatment algorithm for type 2 diabetes: A Joint statement by International Diabetes organizations. Diabetes Care 2016;39:861−77.
28. Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2015;386:964−73.
29. Kavalkova P, Mraz M, Trachta P, et al. Endocrine effects of duodenal-jejunal exclusion in obese patients with type 2 diabetes mellitus. J Endocrinol 2016;231:11−22.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2019 Issue 2
Most read in this issue
- Gastric bypass and its role in metabolic and bariatric surgery
- Unusual complications after bariatric surgery − gastric plication
- Wernicke´s encephalopathy as rare complication after sleeve gastrectomy
- SADIS − Single anastomosis duodeno-ileal bypass with sleeve gastrectomy as a second step after sleeve gastrectomy