Diabetes and its complications: Therapies Available, Anticipated and Aspired

2020 ◽  
Vol 16 ◽  
Author(s):  
Anu Grover ◽  
Komal Sharma ◽  
Suresh Gautam ◽  
Srishti Gautam ◽  
Monica Gulati ◽  
...  

: Diabetes Mellitus is characterized as a set of metabolic disorders that have hyperglycemia in common, caused by defects in the action and / or in the secretion of insulin. It is a noncommunicable disease, considered one of the main public health problems and of widespread growth in the world, a difficult condition to treat and expensive to manage. Metabolic surgery is a safe treatment, regulated by the Federal Council of Medicine and indicated for the treatment of people with a Body Mass Index above 30, who are not successful in controlling pathologies associated with obesity, especially type 2 diabetes. The general objective of this study is to understand through a literature review the main impacts of metabolic surgery on the remission of type 2 Diabetes Mellitus. The present study is an exploratory and descriptive study carried out through a literature review. Data were collected through searches in virtual health databases, at the Virtual Health Library - VHL, Latin American and Caribbean Health Sciences Information System, LILACS, National Library of Medicine - MEDLINE, Scielo, database USP, PUBMED theses and books. Metabolic surgery proves to be an effective treatment to achieve not only sustained weight loss, but also a significant metabolic improvement that goes beyond mere weight loss. Metabolic surgery provides a more effective way to achieve long-term weight loss in obese individuals, increasing overall survival in this group of patients. Obese DM2 patients have a good chance of achieving long-term remission of DM2 after bariatric / metabolic surgery. Therefore, it concludes that such procedure is effective in the treatment of the disease and other diseases associated with obesity.

2020 ◽  
Vol 17 ◽  
Author(s):  
Cejana de Abrantes Figueiredo Baiocchi ◽  
Diana Aristótelis Rocha de Sá ◽  
Alberto Krayyem Arbex

Abstract:: Diabetes Mellitus is characterized by numerous metabolic disorders, which have in common the serum elevation of glucose, caused for a pancreatic malfunction in insulin secretion and / or its action. It is a non-communicable disease, considered major public health problems and generalized growth worldwide, being a chronic disease, which can generate a high treatment cost. Metabolic surgery is a safe treatment, regulated by the Federal Council of Medicine and useful in treating people with BMI over 30 years of age, who are unable to control pathologies associated with obesity, especially type 2 diabetes. The general objective of this study is to understand through a literature review the main impacts of metabolic surgery about the remission of DM 2. This present study it is an exploratory and descriptive study carried out through a literature review. Data were collected through research in virtual health databases, at the Virtual Health Library - VHL, Latin American and Caribbean Health Sciences Information System, LILACS, National Library of Medicine - MEDLINE, Scielo, USP database, PUBMED theses and books. Metabolic surgery proof be a good and effective treatment for having and maintaining good weight loss, as well as a significant clinical and metabolic improvement that extends beyond weight loss. Metabolic surgery is a satisfactory way of achieving long-term weight reduction in obese individuals, increasing survival for these patients. Obese patients with DM2 have a long-term remission of DM2 after bariatric / metabolic surgery. Therefore, it concludes that such procedure is effective in the treatment of the disease and other diseases associated with obesity. 1


2012 ◽  
Vol 36 (5) ◽  
pp. S69-S70
Author(s):  
Pierre Johansen ◽  
Anna R. Teschemaker ◽  
Nicole C. Brazier ◽  
Cheryl Neslusan ◽  
Michael Willis

Author(s):  
David E. Cummings

Faced with the dual pandemics of obesity and type 2 diabetes mellitus, heath care providers require a broad array of treatment options. Diet, exercise, and medications remain the cornerstones of type 2 diabetes therapy, but long-term results with lifestyle modifications can be disappointing, and, despite an ever-increasing armamentarium of pharmacotherapeutics, adequate glycaemic control often remains elusive. Moreover, most diabetes medications promote weight gain, and using them to achieve tight glycaemic control introduces a proportionate risk of hypoglycaemia. In cases where behavioural/pharmacological strategies prove insufficient, gastrointestinal surgery offers powerful alternatives for obesity and type 2 diabetes treatment (Fig. 13.4.5.1). Among severely obese patients, bariatric operations cause profound, sustained weight loss, ameliorating obesity-related comorbidities and reducing long-term mortality (1–4). Operations involving intestinal bypasses exert particularly dramatic antidiabetes effects. For example, approximately 84% of obese patients with type 2 diabetes experience diabetes remission after a Roux-en-Y gastric bypass (RYGB), maintaining euglycaemia off diabetes medications for at least 14 years (1, 5–8). Mounting evidence indicates that these effects result not only from weight loss, but also from weight-independent antidiabetic mechanisms (9). Whereas diabetes is traditionally viewed as a relentless disease in which delay of end-organ complications is the major treatment goal, gastrointestinal surgery offers a novel endpoint: complete disease remission. Consequently, conventional bariatric procedures and experimental gastrointestinal manipulations are being used worldwide to treat type 2 diabetes in association with obesity, and, increasingly, among less obese or merely overweight patients (8). Gastrointestinal surgery also offers valuable research opportunities to improve knowledge of diabetes pathogenesis and help develop less invasive procedures and novel pharmaceuticals. This chapter discusses the effects of gastrointestinal operations on type 2 diabetes, and focuses on potential antidiabetic mechanisms that mediate those effects.


2016 ◽  
Vol 134 (2) ◽  
pp. 184-184 ◽  
Author(s):  
Susan L. Norris ◽  
Xuanping Zhang ◽  
Alison Avenell ◽  
Edward Gregg ◽  
Tamara Brown ◽  
...  

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