The Role of Bariatric Surgery in the Treatment of Type 2 Diabetes in Morbidly Obese Patients

This chapter provides a summary of a landmark study in bariatric surgery. In obese patients with uncontrolled type 2 diabetes, does bariatric surgery plus intensive medical therapy achieve improved glycemic control in significantly more patients than medical therapy alone? Starting with that question, this chapter describes the basics of the study, including funding, study location, who was studied, who was excluded, how many patients, study design, study intervention, follow-up, endpoints, results, criticisms, and limitations. The chapter also briefly reviews other relevant studies and information, discusses implications and concludes with a relevant clinical case about bariatric surgery for a morbidly obese female patient with a BMI of 37 and type 2 diabetes.

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Update on the Mechanisms Facilitating Weight Loss and Resolution of Type 2 Diabetes Following Bariatric Surgery

Romanian Journal of Diabetes Nutrition and Metabolic Diseases ◽

10.2478/v10255-012-0049-6 ◽

2012 ◽

Vol 19 (4) ◽

pp. 425-432

Author(s):

Cornelia Zetu ◽

Rubin Munteanu ◽

Anca Frunză ◽

Constantin Ionescu-Tîrgovişte

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Body Mass Index ◽

Weight Loss ◽

Morbidly Obese ◽

Obese Patients ◽

Glucose Profiles ◽

Obese Subjects

AbstractThe prevalence of type 2 diabetes mellitus (T2DM) and obesity is steadily increasingworldwide. To fight the twin pandemics of obesity and T2DM, clinicians need everytool they can get. Major, durable weight loss is uncommon with medical andbehavioral approaches; many diabetes drugs promote weight gain, while using themto obtain better blood glucose profiles increases the risk of hypoglycemia. Bariatricsurgery seems to be the most effective method for promoting major and durableweight loss in obese subjects, leading also to ameliorations of obesity-associated comorbidities,especially T2DM. Currently, indications for bariatric surgery includemorbidly obese patients or patients with a body mass index (BMI) >35 withsignificant co-morbidities. Currently, bariatric surgery (also referred to as“metabolic surgery”) is advocated for the treatment of T2DM even in overweightsubjects who do not meet the current BMI criteria. This review examines the currentevidence regarding the mechanisms of T2DM resolution following bariatric surgery.

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Impact of bariatric surgery on type 2 diabetes in morbidly obese patients and its correlation with pre-operative prediction scores

Journal of Minimal Access Surgery ◽

10.4103/jmas.jmas_19_20 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Sandeep Aggarwal ◽

Mehul Gupta ◽

Amit Bhambri ◽

Vitish Singla ◽

Rachna Chaudhary

Keyword(s):

Type 2 Diabetes ◽

Bariatric Surgery ◽

Morbidly Obese ◽

Obese Patients

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Effects of Laparoscopic Roux-en-Y Gastric Bypass on Anthropometric Characteristics, Hypertension, Type 2 Diabetes Mellitus and Metabolic Syndrome: An Iranian Experience

Galen Medical Journal ◽

10.31661/gmj.v3i3.163 ◽

2014 ◽

Vol 3 (3) ◽

pp. 167-75

Author(s):

Morteza Ghoghaei ◽

Elias Khajeh ◽

Foad Taghdiri ◽

Mohammad Mahdi Zamani ◽

Soudeh Taghdiri ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Bariatric Surgery ◽

Metabolic Syndrome ◽

Weight Loss ◽

Gastric Bypass ◽

Type 2 Diabetes Mellitus ◽

Morbidly Obese ◽

Obese Patients

Background: Surgically induced weight loss is a treatment option for the management of obesity and the related common disorders. This study evaluated the beneficial effects of bariatric surgery on metabolic profile and the prevalence of metabolic syndrome (MetS) among Iranian patients.Materials and Methods: A prospective observational study was performed on 26 morbidly obese patients scheduled for bariatric surgery, using laparoscopic Roux-en-Y gastric bypass (LRYGB). The parameters of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemia, MetS prevalence, and anthropometric measurements of Iranian patients, were recorded, at the preoperative visit and in follow-ups. The follow-up was performed for a median of 12 months, and the change in MetS prevalence and its componnts were assesed.Results: LRYGB induced a mean weight loss of 69.0±21.2%, after 12 months. Preoperative MetS was diagnosed in 21 patients (84%) and decreased to 6 patients (24%) after LRYGB (P=0.001). Likewise, the prevalence of hypertension was significantly decreased from 76% (pre-LRYGB values) to 20% (post-LRYGB values) (P=0.001). The prevalence of T2DM was also decreased from 20% to 8% (P=0.5).Conclusion: According to our results, RYGB produced a rapid and significant weight loss and improvement in hypertension and MetS within one year but there was a controversy about the improvement of T2DM, in Iranian morbidly obese patients.

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