J Korean Diabetes.  2019 Sep;20(3):136-141. 10.4093/jkd.2019.20.3.136.

Bariatric/Metabolic Surgery and Type 2 Diabetes

• Kim JH

• KMID: 2458962
• DOI: http://doi.org/10.4093/jkd.2019.20.3.136

Abstract

When type 2 diabetes and obesity occur together, disease burden is increased and this is an important public health concern due to the deleterious effects. Despite continuing advances in pharmacological approaches to diabetes, diabetes still remains a chronic, progressive, and irreversible disease. Recently, bariatric surgery, initially developed to treat severe obesity, has attracted growing interest for its beneficial effects on improvement in glucose outcomes and type 2 diabetes remission. Several studies suggest considering this surgery as metabolic surgery because it leads to improvement in obesity-related metabolic comorbidities. The Diabetes Surgery Summit recently recommended inclusion of bariatric surgery among glucose-lowering interventions for type 2 diabetes and obesity. Bariatric surgery can be considered as one effective treatment option and may present an appropriate opportunity to improve prognosis in selected people with type 2 diabetes.

Keyword

Bariatric surgery; Diabetes mellitus, type 2

MeSH Terms

Bariatric Surgery
Comorbidity
Diabetes Mellitus, Type 2
Glucose
Obesity
Obesity, Morbid
Prognosis
Public Health
Glucose

Reference

1. NCD Risk Factor Collaboration (NCD-RisC). Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19•2 million participants. Lancet. 2016; 387:1377–1396.

2. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4.4 million participants. Lancet. 2016; 387:1513–1513.

3. Pappachan JM, Viswanath AK. Medical management of diabesity: do we have realistic targets? Curr Diab Rep. 2017; 17:4.

4. Cummings DE, Rubino F. Metabolic surgery for the treatment of type 2 diabetes in obese individuals. Diabetologia. 2018; 61:257–264.

5. Pareek M, Schauer PR, Kaplan LM, Leiter LA, Rubino F, Bhatt DL. Metabolic surgery: weight loss, diabetes, and beyond. J Am Coll Cardiol. 2018; 71:670–687.

6. Bhandari M, Fobi MAL, Buchwald JN. the Bariatric Metabolic Surgery Standardization (BMSS) Working Group. Standardization of bariatric metabolic procedures: world consensus meeting statement. Obes Surg. 2019; 29(Suppl 4):309–345.

7. Buchwald H, Buchwald JN. Metabolic (bariatric and nonbariatric) surgery for type 2 diabetes: a personal perspective review. Diabetes Care. 2019; 42:331–340.

8. Nguyen NT, Varela JE. Bariatric surgery for obesity and metabolic disorders: state of the art. Nat Rev Gastroenterol Hepatol. 2017; 14:160–169.

9. MacDonald KG Jr, Long SD, Swanson MS, Brown BM, Morris P, Dohm GL, Pories WJ. The gastric bypass operation reduces the progression and mortality of noninsulin-dependent diabetes mellitus. J Gastrointest Surg. 1997; 1:213–220. discussion 220.

10. Sugerman HJ, Wolfe LG, Sica DA, Clore JN. Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg. 2003; 237:751–756. discussion 757-8.

11. Polyzogopoulou EV, Kalfarentzos F, Vagenakis AG, Alexandrides TK. Restoration of euglycemia and normal acute insulin response to glucose in obese subjects with type 2 diabetes following bariatric surgery. Diabetes. 2003; 52:1098–1103.

12. Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, Eid GM, Mattar S, Ramanathan R, Barinas-Mitchel E, Rao RH, Kuller L, Kelley D. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg. 2003; 238:467–484. discussion 84-5.

13. Sjöström L, Peltonen M, Jacobson P, Ahlin S, Andersson-Assarsson J, Anveden Å, Bouchard C, Carlsson B, Karason K, Lönroth H, Näslund I, Sjöström E, Taube M, Wedel H, Svensson PA, Sjöholm K, Carlsson LM. Association of bariatric surgery with long-term remission of type 2 diabetes and with microvascular and macrovascular complications. JAMA. 2014; 311:2297–2304.

14. Cummings DE, Cohen RV. Bariatric/metabolic surgery to treat type 2 diabetes in patients with a BMI <35 kg/m2. Diabetes Care. 2016; 39:924–933.

15. Schauer PR, Mingrone G, Ikramuddin S, Wolfe B. Clinical outcomes of metabolic surgery: efficacy of glycemic control, weight loss, and remission of diabetes. Diabetes Care. 2016; 39:902–911.

16. Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, Barakat HA, deRamon RA, Israel G, Dolezal JM. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995; 222:339–350.

17. Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, Bantle JP, Sledge I. Weight and type 2 diabetes after bariatric surgery: systematic review and metaanalysis. Am J Med. 2009; 122:248–256.e5.

18. Batterham RL, Cummings DE. Mechanisms of diabetes improvement following bariatric/metabolic surgery. Diabetes Care. 2016; 39:893–901.

19. Wang GF, Yan YX, Xu N, Yin D, Hui Y, Zhang JP, Han GJ, Ma N, Wu Y, Xu JZ, Yang T. Predictive factors of type 2 diabetes mellitus remission following bariatric surgery: a meta-analysis. Obes Surg. 2015; 25:199–208.

20. Wood GC, Mirshahi T, Still CD, Hirsch AG. Association of DiaRem Score with cure of type 2 diabetes following bariatric surgery. JAMA Surg. 2016; 151:779–781.

21. Billeter AT, Scheurlen KM, Probst P, Eichel S, Nickel F, Kopf S, Fischer L, Diener MK, Nawroth PP, Müller-Stich BP. Meta-analysis of metabolic surgery versus medical treatment for microvascular complications in patients with type 2 diabetes mellitus. Br J Surg. 2018; 105:168–181.

22. Fisher DP, Johnson E, Haneuse S, Arterburn D, Coleman KJ, O'Connor PJ, O'Brien R, Bogart A, Theis MK, Anau J, Schroeder EB, Sidney S. Association between bariatric surgery and macrovascular disease outcomes in patients with type 2 diabetes and severe obesity. JAMA. 2018; 320:1570–1582.

23. Rubino F, Nathan DM, Eckel RH, Schauer PR, Alberti KG, Zimmet PZ, Del Prato S, Ji L, Sadikot SM, Herman WH, Amiel SA, Kaplan LM, Taroncher-Oldenburg G, Cummings DE. Delegates of the 2nd Diabetes Surgery Summit. Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by International Diabetes Organizations. Diabetes Care. 2016; 39:861–877.

24. Aminian A, Brethauer SA, Kirwan JP, Kashyap SR, Burguera B, Schauer PR. How safe is metabolic/diabetes surgery. Diabetes Obes Metab. 2015; 17:198–201.

25. Schulman AR, Thompson CC. Complications of bariatric surgery: what you can expect to see in your GI practice. Am J Gastroenterol. 2017; 112:1640–1655.

26. Mingrone G, Bornstein S, Le Roux CW. Optimisation of follow-up after metabolic surgery. Lancet Diabetes Endocrinol. 2018; 6:487–499.