Pros and cons of Roux en-Y gastric bypass surgery in obese patients with type 2 diabetes
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Pros and cons of Roux en-Y gastric bypass surgery in obese patients with type 2 diabetes. / Justinussen, Tummas; Madsbad, Sten; Holst, Jens Juul; Bojsen-Moller, Kirstine Nyvold.
In: Expert Review of Endocrinology & Metabolism, Vol. 14, No. 4, 2019, p. 243-257.Research output: Contribution to journal › Review › Research › peer-review
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TY - JOUR
T1 - Pros and cons of Roux en-Y gastric bypass surgery in obese patients with type 2 diabetes
AU - Justinussen, Tummas
AU - Madsbad, Sten
AU - Holst, Jens Juul
AU - Bojsen-Moller, Kirstine Nyvold
PY - 2019
Y1 - 2019
N2 - Introduction: The worldwide prevalence of obesity and type 2 diabetes (T2D) constitutes an epidemic that is a threat to public health. Bariatric surgery, including Roux en-Y gastric bypass (RYGB), is currently the most effective treatment to induce long-term weight loss and remission of co-morbid conditions. Surgery, however, comes with an added risk of complications, highlighting the need to understand the comparative effectiveness and risks of surgical versus conventional approaches to the treatment of obesity and T2D. Areas covered: Positive and negative outcomes of RYGB surgery in patients with T2D are assessed, with a primary focus on RYGB surgery versus standard non-surgical treatment of obese patients with T2D in randomized clinical trials or high-quality observational cohorts. Searches were conducted in the PubMed database up to 11 April 2019 for relevant studies. Expert opinion: High-level evidence reveals that RYGB ameliorates the clinical manifestations of T2D to a significantly higher degree than medical therapy. Postoperative incidence of beneficial effects and complications, however, differ across subgroups of patients with different preoperative characteristics. Key knowledge gaps, particularly on long-term complications, microvascular- and macrovascular events, and mortality should be addressed, so treatment with RYGB can be applied in an individualized approach to maximize benefits and minimize complications.
AB - Introduction: The worldwide prevalence of obesity and type 2 diabetes (T2D) constitutes an epidemic that is a threat to public health. Bariatric surgery, including Roux en-Y gastric bypass (RYGB), is currently the most effective treatment to induce long-term weight loss and remission of co-morbid conditions. Surgery, however, comes with an added risk of complications, highlighting the need to understand the comparative effectiveness and risks of surgical versus conventional approaches to the treatment of obesity and T2D. Areas covered: Positive and negative outcomes of RYGB surgery in patients with T2D are assessed, with a primary focus on RYGB surgery versus standard non-surgical treatment of obese patients with T2D in randomized clinical trials or high-quality observational cohorts. Searches were conducted in the PubMed database up to 11 April 2019 for relevant studies. Expert opinion: High-level evidence reveals that RYGB ameliorates the clinical manifestations of T2D to a significantly higher degree than medical therapy. Postoperative incidence of beneficial effects and complications, however, differ across subgroups of patients with different preoperative characteristics. Key knowledge gaps, particularly on long-term complications, microvascular- and macrovascular events, and mortality should be addressed, so treatment with RYGB can be applied in an individualized approach to maximize benefits and minimize complications.
KW - Gastric bypass
KW - type 2 diabetes
KW - obesity
KW - diabetes remission
KW - complications
KW - bariatric surgery
KW - microvascular outcomes
KW - macrovascular outcomes
KW - dyslipidemia
KW - hypertension
U2 - 10.1080/17446651.2019.1628639
DO - 10.1080/17446651.2019.1628639
M3 - Review
C2 - 31215828
VL - 14
SP - 243
EP - 257
JO - Expert Review of Endocrinology and Metabolism
JF - Expert Review of Endocrinology and Metabolism
SN - 1744-6651
IS - 4
ER -
ID: 225957605