The Impact of Bariatric Surgery in Patients with Type-2 Diabetes Mellitus
The Impact of Bariatric Surgery in Patients with Type-2 Diabetes Mellitus
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DOI：
10.2174/157339911795843087
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发表时间：
2011-01-01
影响因子：
3.3
通讯作者：
Karmali, Shahzeer
中科院分区：
文献类型：
--
作者：
Gill, Richdeep S.;Sharma, Arya M.;Karmali, Shahzeer
全世界有超过2.2亿人患有2型糖尿病（T2DM）。肥胖已被确定为T2DM发展的重要风险因素。超重或肥胖个体发展胰岛素抵抗，导致高胰岛素血症。这一过程可能进展为葡萄糖耐受不良受损，最终发展为T2DM。有强有力的证据表明，减肥手术可能会产生可持续的长期减肥肥胖的个人。减肥手术包括主要分为限制性或吸收不良的手术。限制性减肥手术包括胃束带术或袖状胃切除术，而吸收不良手术包括胃旁路术和胆胰分流术。已证明吸收不良手术在产生显著体重减轻沿着T2 DM消退或改善方面具有上级优势。有趣的是，已显示在吸收不良减肥手术后不久，在显著体重减轻之前，糖尿病的改善发生，这表明可能涉及脂肪介导的机制。随着肥胖和T2DM的患病率持续上升，减肥手术在对抗这种日益严重的流行病中的作用也可能增加。
Over 220 million individuals have type-2 diabetes mellitus (T2DM) worldwide. Obesity has been identified as a significant risk factor for the development of T2DM. Overweight or obese individuals develop insulin resistance with resultant hyperinsulinemia. This process may progress to impaired glucose intolerance and eventual T2DM. There is strong evidence indicating that bariatric surgery may produce sustainable long-term weight loss in obese individuals. Bariatric surgery consists of surgical operations classified as either primarily restrictive or malabsorptive. Restrictive bariatric procedures include gastric banding or sleeve gastrectomy, while malabsorptive procedures included gastric bypass and biliopancreatic diversion. Malabsorptive procedures have been shown to be superior in producing dramatic weight loss along with resolution or improvement of T2DM. Interestingly, improvement of diabetes has been shown to occur shortly following malabsorptive bariatric surgery, prior to significant weight loss, suggesting that hormone-mediated mechanisms may be involved. As the prevalence of obesity and T2DM continues to rise, so may the role of bariatric surgery to combat this growing epidemic.