Document Detail


Metabolic surgery to treat type 2 diabetes: clinical outcomes and mechanisms of action.
MedLine Citation:
PMID:  20059345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Several gastrointestinal (GI) operations that were designed to promote weight loss can powerfully ameliorate type 2 diabetes mellitus (T2DM). Although T2DM is traditionally viewed as a chronic, relentless disease in which delay of end-organ complications is the major treatment goal, GI surgery offers a novel endpoint: complete disease remission. Ample data confirm the excellent safety and efficacy of conventional bariatric operations-especially Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding-to treat T2DM in severely obese patients. Use of experimental procedures as well as conventional bariatric operations is increasingly being explored in less obese diabetic patients, with generally favorable results, although further assessment of risk:benefit profiles is needed. Mounting evidence indicates that certain operations involving intestinal diversions improve glucose homeostasis through varied mechanisms beyond reduced food intake and body weight, for example by modulating gut hormones. Research to elucidate such mechanisms should facilitate the design of novel pharmacotherapeutics and dedicated antidiabetes GI manipulations. Here we review evidence regarding the use and study of GI surgery to treat T2DM, focusing on available published reports as well as results from the Diabetes Surgery Summit (DSS) in Rome and the World Congress on Interventional Therapies for T2DM in New York City.
Authors:
Francesco Rubino; Philip R Schauer; Lee M Kaplan; David E Cummings
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Annual review of medicine     Volume:  61     ISSN:  1545-326X     ISO Abbreviation:  Annu. Rev. Med.     Publication Date:  2010  
Date Detail:
Created Date:  2010-01-11     Completed Date:  2010-05-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985151R     Medline TA:  Annu Rev Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  393-411     Citation Subset:  IM    
Affiliation:
Weill Cornell Medical College/New York Presbyterian Hospital, New York, New York, USA. frr2007@med.cornell.edu
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MeSH Terms
Descriptor/Qualifier:
Biliopancreatic Diversion
Diabetes Mellitus, Type 2 / complications,  metabolism*,  surgery*
Gastric Bypass
Gastroplasty
Humans
Laparoscopy
Obesity, Morbid / complications,  metabolism,  surgery
Treatment Outcome
Weight Loss
Grant Support
ID/Acronym/Agency:
DK17047/DK/NIDDK NIH HHS; DK517498/DK/NIDDK NIH HHS; DK61516/DK/NIDDK NIH HHS; DK66568/DK/NIDDK NIH HHS; DK68384/DK/NIDDK NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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