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. 2015 Jul 25;6(8):990-8.
doi: 10.4239/wjd.v6.i8.990.

Metabolic surgery: A paradigm shift in type 2 diabetes management

Joseph M Pappachan  1 , Ananth K Viswanath  1
Affiliations

Metabolic surgery: A paradigm shift in type 2 diabetes management

Joseph M Pappachan et al. World J Diabetes. .

Abstract

Obesity and type 2 diabetes mellitus (T2DM) are major public health issues globally over the past few decades. Despite dietary interventions, lifestyle modifications and the availability of several pharmaceutical agents, management of T2DM with obesity is a major challenge to clinicians. Metabolic surgery is emerging as a promising treatment option for the management of T2DM in the obese population in recent years. Several observational studies and a few randomised controlled trials have shown clear benefits of various bariatric procedures in obese individuals in terms of improvement or remission of T2DM and multiple other health benefits such as improvement of hypertension, obstructive sleep apnoea, osteoarthritis and non-alcoholic fatty liver disease. Uncertainties about the long-term implications of metabolic surgery such as relapse of T2DM after initial remission, nutritional and psychosocial complications and the optimal body mass index for different ethnic groups exist. The article discusses the major paradigm shift in recent years in the management of T2DM after the introduction of metabolic surgery.

Keywords: Bariatric procedures; Body mass index; Diabetes remission; Metabolic surgery; Type 2 diabetes mellitus.

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Figures

Figure 1
Figure 1
The diagrammatic representation of different bariatric surgical procedures. A: Adjustable gastric band; B: Sleeve gastrectomy; C: Roux-en-Y gastric bypass; D: Bilio-pancreatic diversion. Figure reproduced with permission from John Wiley and Sons. Obesity (Silver Spring) 2013 Mar; 21 Suppl 1: S1-27.
See this image and copyright information in PMC

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