Effects of bariatric surgery on glucose homeostasis and type 2 diabetes
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Effects of bariatric surgery on glucose homeostasis and type 2 diabetes. / Bradley, David; Magkos, Faidon; Klein, Samuel.
In: Gastroenterology, Vol. 143, No. 4, 2012, p. 897-912.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Effects of bariatric surgery on glucose homeostasis and type 2 diabetes
AU - Bradley, David
AU - Magkos, Faidon
AU - Klein, Samuel
N1 - Copyright © 2012 AGA Institute. Published by Elsevier Inc. All rights reserved.
PY - 2012
Y1 - 2012
N2 - Obesity is an important risk factor for type 2 diabetes mellitus (T2DM). Weight loss improves the major factors involved in the pathogenesis of T2DM, namely insulin action and beta cell function, and is considered a primary therapy for obese patients who have T2DM. Unfortunately, most patients with T2DM fail to achieve successful weight loss and adequate glycemic control from medical therapy. In contrast, bariatric surgery causes marked weight loss and complete remission of T2DM in most patients. Moreover, bariatric surgical procedures that divert nutrients away from the upper gastrointestinal tract are more successful in producing weight loss and remission of T2DM than those that simply restrict stomach capacity. Although upper gastrointestinal tract bypass procedures alter the metabolic response to meal ingestion, by increasing early postprandial plasma concentrations of glucagon-like peptide 1 and insulin, it is not clear whether these effects make an important contribution to long-term control of glycemia and T2DM once substantial surgery-induced weight loss has occurred. Nonetheless, the effects of surgery on body weight and metabolic function indicate that bariatric surgery should be part of the standard therapy for T2DM. More research is needed to advance our understanding of the physiological effects of different bariatric surgical procedures and possible weight loss-independent factors that improve metabolic function and contribute to the resolution of T2DM.
AB - Obesity is an important risk factor for type 2 diabetes mellitus (T2DM). Weight loss improves the major factors involved in the pathogenesis of T2DM, namely insulin action and beta cell function, and is considered a primary therapy for obese patients who have T2DM. Unfortunately, most patients with T2DM fail to achieve successful weight loss and adequate glycemic control from medical therapy. In contrast, bariatric surgery causes marked weight loss and complete remission of T2DM in most patients. Moreover, bariatric surgical procedures that divert nutrients away from the upper gastrointestinal tract are more successful in producing weight loss and remission of T2DM than those that simply restrict stomach capacity. Although upper gastrointestinal tract bypass procedures alter the metabolic response to meal ingestion, by increasing early postprandial plasma concentrations of glucagon-like peptide 1 and insulin, it is not clear whether these effects make an important contribution to long-term control of glycemia and T2DM once substantial surgery-induced weight loss has occurred. Nonetheless, the effects of surgery on body weight and metabolic function indicate that bariatric surgery should be part of the standard therapy for T2DM. More research is needed to advance our understanding of the physiological effects of different bariatric surgical procedures and possible weight loss-independent factors that improve metabolic function and contribute to the resolution of T2DM.
KW - Animals
KW - Bariatric Surgery
KW - Blood Glucose/metabolism
KW - Diabetes Mellitus, Type 2/blood
KW - Homeostasis
KW - Humans
KW - Insulin/metabolism
KW - Insulin Resistance
KW - Insulin Secretion
KW - Insulin-Secreting Cells/metabolism
KW - Obesity/surgery
U2 - 10.1053/j.gastro.2012.07.114
DO - 10.1053/j.gastro.2012.07.114
M3 - Review
C2 - 22885332
VL - 143
SP - 897
EP - 912
JO - Gastroenterology
JF - Gastroenterology
SN - 0016-5085
IS - 4
ER -
ID: 290033569