Bariatric surgery for type 2 diabetes

@article{Dixon2012BariatricSF,
  title={Bariatric surgery for type 2 diabetes},
  author={John B. Dixon and Carel W. le Roux and Francesco Rubino and Paul Z. Zimmet},
  journal={The Lancet},
  year={2012},
  volume={379},
  pages={2300-2311}
}
Bariatric surgery provides substantial, sustained weight loss and major improvements in glycaemic control in severely obese individuals with type 2 diabetes. However, uptake of surgery in eligible patients is poor, and the barriers are difficult to surmount. We examine the indications for and efficacy and safety of conventional bariatric surgical procedures and their effect on glycaemic control in type 2 diabetes. How surgical gastrointestinal interventions achieve these changes is of great… 
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280 Citations
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280 Citations

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Gastrointestinal weight loss surgery for the management of type 2 diabetes: A view from Greece
TLDR
Evidence is provided that surgical procedures bypassing parts of the small intestine improve glucose homeostasis through mechanisms beyond reduced food intake and body weight, which should facilitate the design of novel anti-diabetic gastrointestinal manipulations, devices and pharmacotherapeutics for obese and non-obese diabetic patients.
Bariatric surgery or medicine for type 2 diabetes?
TLDR
Larger studies are needed to determine whether one of these procedures is better, or if they are all similarly effective, and this should be weighed against the risk of the operations.
Metabolic surgery for type 2 diabetes: efficacy and risks
TLDR
Understanding the efficacy and physiologic effects of bariatric surgery on metabolism will help guide patient management in the context of a growing epidemic of obesity and T2DM, and may also enable us to develop less invasive but equally effective therapeutic strategies for weight loss and metabolic control.
Glycaemic Control and Reduction of Cardiovascular Risk Following Bariatric Surgery
TLDR
This chapter will outline the differential effects of each of the current most common bariatric procedures on CV risk factors.
Assessing the obese diabetic patient for bariatric surgery: which candidate do I choose?
TLDR
At present, Roux-en-Y gastric bypass seems the surgical procedure of choice because it has fewer risks than biliopancreatic diversion, and it is associated with higher weight loss and metabolic improvements compared with adjustable gastric banding.
Gastrointestinal Surgery: Cardiovascular Risk Reduction and Improved Long-Term Survival in Patients with Obesity and Diabetes
TLDR
The opportunity for bariatric (and/or metabolic) surgery to provide a preventive strategy for cardiovascular disease and diabetes as well as treatment therapy is presented for clinical consideration.
Surgery for Severe Obesity
TLDR
This state-of-the-art review focuses on the research and resultant recommendations regarding lifestyle management for patients who have undergone bariatric surgery.
Bariatric surgery as a treatment option in patients with type 2 diabetes mellitus.
TLDR
The elucidation of the mechanisms underpinning the resolution of T2DM following bariatric surgery might result in the development of novel, more effective pharmacotherapies for this common disease.
Bariatric surgery: traversing the CROSSROADS into mainstream diabetes care
TLDR
The CROSSROADS study was very successful in achieving weight loss and reducing markers of metabolic dysfunction, including HbA1c and fasting insulin concentrations in both arms, however, in keeping with previous studies on the effect of intensive lifestyle interventions on metabolic control in diabetes, and on weight loss, the initial improvements were not sustainable without the addition of surgery.
Gastric Bypass for Type 2 Diabetes Mellitus on BMI < 35
TLDR
Bariatric surgery can cause resolution of the clinical manifestations of type 2 diabetes, as well as improvement, and metabolic surgery is the only diabetes treatment proven to result in long-term remission in 23–60% of patients depending upon preoperative duration of diabetes and disease severity.
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