What is the evidence for metabolic surgery for type 2 diabetes? A critical perspective

Abstract Bariatric surgery has emerged as a highly effective treatment not only for obesity, but also for type 2 diabetes (T2D). A meta-analysis has reported the complete resolution of T2D in 78.1% of cases of morbidly obese patients after bariatric surgery. Such extraordinary results obtained in di...

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Bibliographic Details
Published in:Diabetes & metabolism 2017-02, Vol.43 (1), p.9-17
Main Authors: Amouyal, C, Andreelli, F
Format: Article
Language:English
Subjects:
Bariatric Surgery
Diabetes Mellitus, Type 2 - surgery
Endocrinology & Metabolism
Humans
Internal Medicine
Life Sciences
Metabolic surgery
Obesity
Obesity, Morbid - surgery
Type 2 diabetes
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Summary:Abstract Bariatric surgery has emerged as a highly effective treatment not only for obesity, but also for type 2 diabetes (T2D). A meta-analysis has reported the complete resolution of T2D in 78.1% of cases of morbidly obese patients after bariatric surgery. Such extraordinary results obtained in diabetic patients with body mass index (BMI) scores > 35 kg/m2 have led investigators to question whether similar results might be achieved in patients with BMIs < 35 kg/m2 . Preliminary studies suggest that metabolic surgery is safe and effective in patients with T2D and a BMI < 35 kg/m2 , whereas other studies report that metabolic surgery is less effective for promoting T2D remission in these patients. Thus, the results are discordant. Long-term studies would be useful for determining the safety, efficacy and cost-effectiveness of metabolic surgery for this population with T2D. In 2015, it is probably premature to say that metabolic surgery is an accepted treatment option for T2D patients with BMIs < 35 kg/m2.
ISSN:1262-3636
1878-1780
DOI:10.1016/j.diabet.2016.06.005