Bariatric Surgery and Type 2 Diabetes

To the Editor Inge et al have shown that bariatric surgery has a greater association than medical treatment alone in achieving an improvement of type 2 diabetes mellitus and its comorbidities in obese adolescents. The mechanism seems to go beyond the magnitude of weight loss alone and include an improvement in incretin profiles, insulin secretion, and insulin sensitivity.
Source: JAMA Pediatrics - Category: Pediatrics Source Type: research

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Conclusions: Bariatric surgery appears to be capable of partially reversing the obesity-related epigenome. The identification of potential epigenetic biomarkers predictive for the success of bariatric surgery may open new doors to personalized therapy for severe obesity. Introduction Obesity is currently a huge healthcare problem, worldwide, and is a risk factor for several diseases such as type 2 diabetes (T2D), cardiovascular disease and cancer (1). As the prevalence of obesity reaches pandemic proportions, this metabolic disease is estimated to become the biggest cause of mortality in the near future (2). In fact,...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Bariatric surgery is currently the best treatment for type 2 diabetes mellitus (DM2) in patients with obesity. Although different surgical techniques produce different results, better glycemic control is achieved with surgical procedures compared to clinical treatments [1 –3].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Original articles Source Type: research
Conclusions/interpretationFor up to 2  years following RYGB, obese participants without diabetes showed improvements in DI that approach population norms. Those with type 2 diabetes recovered islet-cell insulin secretion response yet continued to manifest abnormal insulin processing, with DI values that remained well below population n orms. These data suggest that, rather than waiting for lifestyle or medical failure, RYGB is ideally considered before, or as soon as possible after, onset of type 2 diabetes.Trial NCT00433810
Source: Diabetologia - Category: Endocrinology Source Type: research
Abstract Major depressive disorder and bipolar disorder are highly prevalent and disabling conditions. Cognition is considered a core domain of their psychopathology and a principle mediator of psychosocial impairment, disproportionately accounting for overall illness-associated costs. There are few interventions with replicated evidence of efficacy in treating cognitive deficits in mood disorders. Evidence also indicates that cognitive deficits are associated with obesity and involve significant impairment across multiple domains. Conversely, weight-loss interventions, such as physical exercise and bariatric surg...
Source: Neuropharmacology - Category: Drugs & Pharmacology Authors: Tags: Neuropharmacology Source Type: research
Increasing worldwide prevalence of type 2 diabetes mellitus and its accompanying pathologies such as obesity, arterial hypertension and dyslipidemia represents one of the most important challenges of current medicine. Despite intensive efforts, high percentage of patients with type 2 diabetes does not achieve treatment goals and struggle with increasing body weight and poor glucose control. While novel classes of antidiabetic medications such as incretin-based therapies and gliflozins have some favorable characteristics compared to older antidiabetics, the only therapeutic option shown to substantially modify the progressi...
Source: Journal of Endocrinology - Category: Endocrinology Authors: Tags: Review Source Type: research
Bile acids (BAs) are cholesterol-derived metabolites that facilitate the intestinal absorption and transport of dietary lipids. Recently, BAs also emerged as pivotal signaling molecules controlling glucose, lipid, and energy metabolism by binding to the nuclear hormone farnesoid X receptor (FXR) and Takeda G protein receptor 5 (TGR5) in multiple organs, leading to regulation of intestinal incretin secretion, hepatic gluconeogenesis, glycogen synthesis, energy expenditure, inflammation, and gut microbiome configuration. Alterations in BA metabolism and signaling are associated with obesity and type 2 diabetes mellitus (T2DM...
Source: The Journal of Experimental Medicine - Category: Internal Medicine Authors: Tags: Metabolism Review Source Type: research
ConclusionsBariatric surgery is a safe and effective procedure to treat T2DM in class I obese patients. It is also superior to advance medical treatment modalities such as GLP-1 analogues and SGLT2 inhibitors.
Source: Obesity Surgery - Category: Surgery Source Type: research
Authors: Ugale S, Agarwal D, Satwalekar V, Rao N, Ugale A Abstract Bariatric surgery has been found to be very useful in treating established type-2 diabetes in obese persons, as well as in borderline diabetics, besides giving a good weight loss. Various modifications of the primary bariatric procedures have been introduced, with differing advantages and better efficacy. Good incretin responses from the distal gut give the best results and combining medical treatment are helping patients to get very good glycemic control over a longer term. PMID: 27270500 [PubMed - as supplied by publisher]
Source: Minerva Endocrinologica - Category: Endocrinology Tags: Minerva Endocrinol Source Type: research
More than 20 years ago, Pories et al. published a seminal article, "Who Would Have Thought It? An Operation Proves to Be the Most Effective Therapy for Adult-Onset Diabetes Mellitus." This was based on their observation that bariatric surgery rapidly normalized blood glucose levels in obese people with type 2 diabetes mellitus (T2DM), and 10 years later, almost 90% remained diabetes free. Pories et al. suggested that caloric restriction played a key role and that the relative contributions of proximal intestinal nutrient exclusion, rapid distal gut nutrient delivery, and the role of gut hormones required further ...
Source: Diabetes Care - Category: Endocrinology Authors: Tags: Metabolic Surgery and the Changing Landscape for Diabetes Care Source Type: research
The objective of this review is to summarize and integrate specific clinical observations from the field of gastric bypass surgery and recent findings in beta cell biology. When considered together, these data sets suggest a previously unrecognized physiological mechanism which may explain how Roux-en-Y gastric bypass (RYGB) surgery mediates the early rapid reversal of hyperglycemia, observed before weight loss, in certain Type 2 Diabetes Mellitus (T2DM) patients. The novel mechanism is based on a recently recognized inhibitory circuit of glucose stimulated insulin secretion driven by dopamine (DA) stored in β-cell ve...
Source: Minerva Endocrinologica - Category: Endocrinology Tags: Minerva Endocrinol Source Type: research
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