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Review
. 2023 Dec;12(2):17-25.
doi: 10.17476/jmbs.2023.12.2.17. Epub 2023 Nov 20.

Metabolic Surgery in Korea

Yeon-Ju Huh  1   2 , Hyuk-Joon Lee  1   3
Affiliations
Review

Metabolic Surgery in Korea

Yeon-Ju Huh et al. J Metab Bariatr Surg. 2023 Dec.

Abstract

Metabolic surgery (MS) is a surgery that focuses on improving obesity-related comorbidities. It is often referred to as "diabetic surgery" because of its focus on treating type 2 diabetes. MS is distinguished from bariatric surgery (BS), in which weight loss is the primary goal. However, from a broader perspective, all surgeries for obese patients with diabetes can be considered MS. In Korea, metabolic and bariatric surgery (MBS) has been covered by the national health insurance since 2019. Patients with a body mass index (BMI) ≥35 or those with a BMI ≥30 and obesity-related comorbidities were eligible for MBS. Simultaneously, MS for patients with BMI values between 27.5 and 30 was partly reimbursed. The two major metabolic surgeries are Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG). According to the registry of the Korean Society of Metabolic and Bariatric Surgery, 1,560 metabolic surgeries for obese patients with diabetes were performed between 2019 and 2021 in Korea, which was approximately 35.6% of all bariatric surgeries. SG was the most common, followed by RYGB and duodenal switch surgery. When dividing the patients with diabetes who underwent MBS into two groups, specifically those with BMI <35 and ≥35, we found that SG was performed most common procedure in both groups. However, there was a higher proportion of RYGB and duodenal switch operation in the former, indicating a difference in surgical methods between the two groups. MS is a promising tool for the management of poorly controlled diabetes. More data are needed to establish proper patient selection and choice of surgical type.

Keywords: Diabetes mellitus; Gastrectomy; Gastric bypass; Metabolic surgery; Obesity, morbid.

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Conflict of interest statement

Conflict of Interest: None of the authors have any conflict of interest.

Figures

Fig. 1
Fig. 1. Proportion of diabetes according to the body mass index (2019–2021).
DM = diabetes mellitus.
Fig. 2
Fig. 2. Comparison of the characteristics and operation types of patients who underwent bariatric, metabolic, and pure metabolic surgery (2019).
The data in this figure is for patients who had surgery in 2019, and the data was collected in August 2020. DM = diabetes mellitus; BMI = body mass index.
See this image and copyright information in PMC

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