Effects of Bariatric Surgery in Type 2 Diabetes Mellitus

Yu-Na Kim; Yeon Hee Lee; Chong Hwa Kim

Article

Korean J Obes 2014; 23(4): 231-235

Published online December 30, 2014

Effects of Bariatric Surgery in Type 2 Diabetes Mellitus

Yu-Na Kim¹, Yeon Hee Lee², Chong Hwa Kim^1.*

Author Affiliations

¹Department of Internal Medicine, Sejong General Hospital, Bucheon; ²Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract
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Bariatric surgery is considered to be the most effective treatment modality in maintaining long-term weight reduction and improving obesityrelated conditions in patients who are morbidly obese. Recent studies have shown that bariatric surgery can lead to the remission of diabetes in a large portion of patients with both type 2 diabetes and morbid obesity. Although there are some endoscopic bariatric procedures, the most commonly performed bariatric surgeries are Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), sleeve gastrectomy (SG), and biliopancreatic diversion (BPD). The effect of bariatric surgery, especially Roux-en-Y gastric bypass, is thought to be caused by mechanisms other than weight loss that contribute to the metabolic improvement. Improvement in surgery and improved peripheral insulin resistance seen with weight loss are one of the mechanisms leading to improved metabolism. Insulin secretion and altered gut hormone secretion also seem to play a role in this improvement. The mechanisms underlying the beneficial effect of bariatric surgery need to be studied further and this increased understanding will aid in the understanding of the pathophysiology of type 2 diabetes, and may lead to the development of novel therapies.

Keywords: Type 2 diabetes mellitus, Surgery, Bariatric

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References

Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am 1967;47:1345-51.
Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev 2009;CD003641.
Sj?str?m L, Narbro K, Sj?str?m CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 2007;357:741-52.
Sj?str?m L, Lindroos AK, Peltonen M, Torgerson J, Bouchard C, Carlsson B, et al. Lifestyle, diabetes, cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004;351:2683-93.
Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 2009;122:248-56.
Schauer PR, Kashyap SR, Wolski K, Brethauer SA, Kirwan JP, Pothier CE, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med 2012;366:1567-76.
Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Leccesi L, et al. Bariatric surgery versus conventional medical therapy for type 2 diabetes. N Engl J Med 2012;366:1577-85.
Dixon JB, O’Brien PE, Playfair J, Chapman L, Schachter LM, Skinner S, et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 2008;299:316-23.
Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med 2014;370:2002-13.
Stefater MA, Wilson-P?rez HE, Chambers AP, Sandoval DA, Seeley RJ. All bariatric surgeries are not created equal: insights from mechanistic comparisons. Endocr Rev 2012;33:595-622.
Cummings DE. Endocrine mechanisms mediating remission of diabetes after gastric bypass surgery. Int J Obes (Lond) 2009;33 Suppl 1:33-40.
Karra E, Yousseif A, Batterham RL. Mechanisms facilitating weight loss and resolution of type 2 diabetes following bariatric surgery. Trends Endocrinol Metab 2010;21:337-44.
Dixon JB, le Roux CW, Rubino F, Zimmet P. Bariatric surgery for type 2 diabetes. Lancet 2012;379:2300-11.
Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 2009;122:248-56. e5.
Rubino F, R’bibo SL, del Genio F, Mazumdar M, McGraw TE. Metabolic surgery: the role of the gastrointestinal tract in diabetes mellitus. Nat Rev Endocrinol 2010;6:102-9.
Hayes MT, Hunt LA, Foo J, Tychinskaya Y, Stubbs RS. A model for predicting the resolution of type 2 diabetes in severely obese subjects following Roux-en Y gastric bypass surgery. Obes Surg 2011;21:910-6.
Patriti A, Facchiano E, Annetti C, Aisa MC, Galli F, Fanelli C, et al. Early improvement of glucose tolerance after ileal transposition in a non-obese type 2 diabetes rat model. Obes Surg 2005;15:1258-64.
Dirksen C, Jørgensen NB, Bojsen-Møller KN, Jacobsen SH, Hansen DL, Worm D, et al. Mechanisms of improved glycaemic control after Roux-en-Y gastric bypass. Diabetologia 2012;55:1890-901.
Kirk E, Reeds DN, Finck BN, Mayurranjan SM, Patterson BW, Klein S. Dietary fat and carbohydrates differentially alter insulin sensitivity during caloric restriction. Gastroenterology 2009;136:1552-60.
Lim EL, Hollingsworth KG, Aribisala BS, Chen MJ, Mathers JC, Taylor R. Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol. Diabetologia 2011;54:2506-14.
Kashyap SR, Daud S, Kelly KR, Gastaldelli A, Win H, Brethauer S, et al. Acute effects of gastric bypass versus gastric restrictive surgery on beta-cell function and insulinotropic hormones in severely obese patients with type 2 diabetes. Int J Obes (Lond) 2010;34:462-71.
Umeda LM, Silva EA, Carneiro G, Arasaki CH, Geloneze B, Zanella MT. Early improvement in glycemic control after bariatric surgery and its relationships with insulin, GLP-1, glucagon secretion in type 2 diabetic patients. Obes Surg 2011;21:896-901.
Nannipieri M, Mari A, Anselmino M, Baldi S, Barsotti E, Guarino D, et al. The role of beta-cell function and insulin sensitivity in the remission of type 2 diabetes after gastric bypass surgery. J Clin Endocrinol Metab 2011;96:E1372-9.
Laferr?re B, Heshka S, Wang K, Khan Y, McGinty J, Teixeira J, et al. Incretin levels and effect are markedly enhanced 1 month after Roux-en-Y gastric bypass surgery in obese patients with type 2 diabetes. Diabetes Care 2007;30:1709-16.
Laferr?re B, Teixeira J, McGinty J, Tran H, Egger JR, Colarusso A, et al. Effect of weight loss by gastric bypass surgery versus hypocaloric diet on glucose and incretin levels in patients with type 2 diabetes. J Clin Endocrinol Metab 2008;93:2479-85.
Korner J, Bessler M, Cirilo LJ, Conwell IM, Daud A, Restuccia NL, et al. Effects of Roux-en-Y gastric bypass surgery on fasting and postprandial concentrations of plasma ghrelin, peptide YY, insulin. J Clin Endocrinol Metab 2005;90:359-65.
Cummings DE, Weigle DS, Frayo RS, Breen PA, Ma MK, Dellinger EP, et al. Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. N Engl J Med 2002;346:1623-30.