Reference : Bariatric surgery in patients with Type 2 diabetes: benefits, risks, indications and per...
Scientific journals : Article
Human health sciences : Surgery
Human health sciences : Endocrinology, metabolism & nutrition
http://hdl.handle.net/2268/58946
Bariatric surgery in patients with Type 2 diabetes: benefits, risks, indications and perspectives.
English
Scheen, André mailto [Université de Liège - ULg > Département des sciences cliniques > Diabétologie, nutrition et maladie métaboliques - Médecine interne générale >]
De Flines, Jenny mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]
De Roover, Arnaud mailto [Centre Hospitalier Universitaire de Liège - CHU > > Chirurgie abdominale- endocrinienne et de transplantation >]
Paquot, Nicolas mailto [Centre Hospitalier Universitaire de Liège - CHU > > Diabétologie,nutrition, maladies métaboliques >]
2009
Diabètes & Métabolism
Masson
35
6 Pt 2
537-43
Yes (verified by ORBi)
International
1262-3636
Moulineaux Cedex 9
France
[en] Bariatric surgery ; Type 2 diabetes ; Obesity ; Gastroplasty ; Gastric bypass
[en] Obesity plays a key role in the pathophysiology of type 2 diabetes (T2DM), and weight loss is a major objective, although difficult to achieve with medical treatments. Bariatric surgery has proven its efficacy in obtaining marked and sustained weight loss, and is also associated with a significant improvement in glucose control and even diabetes remission. Roux-en-Y gastric bypass appears to be more effective in diabetic patients than the restrictive gastroplasty procedure. This may be explained not only by greater weight reduction, but also by specific hormonal changes. Indeed, increased levels of glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) may lead to improved beta-cell function and insulin secretion as well as reduced insulin resistance associated with weight loss. The presence of T2DM in obese individuals is a further argument to propose bariatric surgery, and even more so when diabetes is difficult to manage by medical means and other weight-related complications may occur. Bariatric surgery is associated with a better cardiovascular prognosis and reduced mortality, even though acute and long-term complications are present. The observation that surgical rerouting of nutrients triggers changes in the release of incretin hormones that, in turn, ameliorate the diabetic state in the absence of weight loss has led to the recent development of innovative surgical procedures. Thus, bariatric surgery may be said to be progressing towards so-called 'metabolic surgery', which merits further evaluation in patients with T2DM within a multidisciplinary approach that involves both surgeons and endocrinologists.
Researchers ; Professionals ; Students
http://hdl.handle.net/2268/58946
10.1016/S1262-3636(09)73463-9
http://www.em-consulte.com/article/242774
Copyright 2009 Elsevier Masson SAS. All rights reserved.

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