Document Detail


Surgical approaches for the prevention and treatment of type 2 diabetes mellitus.
MedLine Citation:
PMID:  19829176     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Lifestyle modifications and pharmacologic therapy have been the mainstays of treatment for patients with type 2 diabetes mellitus. Bariatric surgery, originally designed as a weight loss treatment, has been proven to ameliorate and even cure diabetes. The significant improvement in glycemic control found after bariatric surgery in patients with diabetes often precedes major weight loss. Therefore, a weight-independent mechanism has been thought to initiate this amelioration in glucose control. Reviews of the recent literature question the goal of bariatric surgery, not only to treat obesity through restriction and malabsorption, but also as a possible treatment for diabetes regardless of the degree of obesity. Procedures such as Roux-en-Y gastric bypass, adjustable gastric banding, and biliopancreatic diversion have proven to be extremely effective in controlling diabetes mellitus. Mechanisms explaining the effectiveness of weight reduction surgery include effects on incretins, ghrelin secretion, and insulin sensitivity. Some centers have been performing gastric bypass surgeries on patients with a lower body mass index than that recommended by current NIH guidelines. New considerations for recommending bypass surgery are warranted as the indications for antiobesity surgeries grow to encompass both the treatment and cure of diabetes.
Authors:
Samuel Coffin; Chandana Konduru; Monica Schwarcz; William Frishman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Cardiology in review     Volume:  17     ISSN:  1538-4683     ISO Abbreviation:  Cardiol Rev     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-10-15     Completed Date:  2010-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9304686     Medline TA:  Cardiol Rev     Country:  United States    
Other Details:
Languages:  eng     Pagination:  275-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Vanderbilt School of Medicine, Vanderbilt Hospital, Nashville, TN, USA.
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MeSH Terms
Descriptor/Qualifier:
Bariatric Surgery*
Blood Glucose / metabolism
Diabetes Mellitus, Type 2 / physiopathology,  prevention & control*,  surgery*
Humans
Insulin Resistance / physiology
Weight Loss / physiology
Chemical
Reg. No./Substance:
0/Blood Glucose

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


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