Duodenal exclusion devices: promising tools in treating obesity and type 2 diabetes.
Duodenal exclusion devices: promising tools in treating obesity and type 2 diabetes.
复制标题
十二指肠排除装置：治疗肥胖和 2 型糖尿病的有前途的工具。
DOI：
10.1136/gutjnl-2013-306040
复制
发表时间：
2014
期刊：
影响因子：
24.5
通讯作者：
Cummings,BethanyP
中科院分区：
文献类型：
--
作者：
Cummings,BethanyP
The prevalence of obesity and type 2 diabetes is increasing worldwide at an alarming rate. As of 2008, the worldwide prevalence of type 2 diabetes was estimated to be approximately 9% of the global adult population. 1 While pharmacotherapeutic options for the treatment of type 2 diabetes are expanding, patients suffering from type 2 diabetes continue to experience a significantly higher risk of developing comorbidities such as cardiovascular disease, kidney disease and cancer. 2 Therefore, the development of new therapeutic modalities for the treatment of obesity and type 2 diabetes is crucial.Bariatric surgery is currently considered the most effective therapeutic modality for the long-term treatment of obesity. 3 Furthermore, certain bariatric procedures have been reported to result in relatively high rates of type 2 diabetes resolution. It is important to note that variation exists in the efficacy of different bariatric procedures to produce diabetes resolution. For example, gastric banding has been reported to result in diabetes resolution rates of around 55%; however, Roux en Y Gastric Bypass (RYGB) results in type 2 diabetes resolution rates of approximately 82% and biliopancreatic diversion can produce diabetes remission rates of 94%. 3 Nevertheless, the underlying mechanisms responsible for the blood glucose lowering effects of bariatric surgery remain undefined, although many potential candidate mechanisms have been proposed. RYGB is one of the more commonly performed clinical bariatric procedures and involves several major anatomic alterations, including: reduction of gastric volume, shortening of small intestinal length, movement of the distal small intestine closer to incoming nutrients from the stomach and bypass of the proximal small intestine. Bypass of the proximal small intestinal has been proposed to be an important contributor to the metabolic benefits of RYGB surgery. 4 A strength of the duodenalendoluminal sleeve (DES) model is that it
