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Published in: Current Diabetes Reports 11/2018

01-11-2018 | Therapies and New Technologies in the Treatment of Diabetes (M Pietropaolo, Section Editor)

Metabolic Surgery as a Treatment Option for Type 2 Diabetes Mellitus: Surgical View

Authors: Eric Rachlin, Carlos Galvani

Published in: Current Diabetes Reports | Issue 11/2018

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Abstract

Purpose of Review

Type 2 diabetes mellitus (T2DM) is increasing in prevalence and associated with numerous metabolic complications leading to increased mortality and costs. Metabolic surgery, or surgery to treat T2DM and obesity, is effective at achieving remission from T2DM. This review discusses the most commonly used surgical options including the adjustable gastric band, the Roux-en-Y gastric bypass, the sleeve gastrectomy, and the biliopancreatic diversion with duodenal switch and their ability to treat and prevent T2DM.

Recent Findings

There is an increasing body of literature that justifies the inclusion of metabolic surgery into the treatment algorithm for patients with obesity and T2DM. Metabolic procedures should be performed at centers that offer comprehensive treatment of metabolic disorders and have expertise in gastrointestinal surgery. The incremental improvement in the quality and safety of metabolic surgery has significantly reduced the risk of serious post-operative complications.

Summary

Metabolic surgery is a safe and effective treatment option for obese patients with T2DM.
Literature
4.
go back to reference Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352(11):1138–45.CrossRefPubMed Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, et al. A potential decline in life expectancy in the United States in the 21st century. N Engl J Med. 2005;352(11):1138–45.CrossRefPubMed
5.
go back to reference Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–9.CrossRefPubMed Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA. 2003;289(1):76–9.CrossRefPubMed
11.
go back to reference Gastrointestinal surgery for severe obesity. NIH consensus development conference, March 25-7, 1991. Nutrition 1996;12(6):397–404 Gastrointestinal surgery for severe obesity. NIH consensus development conference, March 25-7, 1991. Nutrition 1996;12(6):397–404
12.
go back to reference Rubino F, Nathan DM, Eckel RH, Schauer PR, Alberti KG, Zimmet PZ, et al. Delegates of the 2nd Diabetes Surgery Summit metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care. 2016;39(6):861–77. https://doi.org/10.2337/dc16-0236.CrossRefPubMed Rubino F, Nathan DM, Eckel RH, Schauer PR, Alberti KG, Zimmet PZ, et al. Delegates of the 2nd Diabetes Surgery Summit metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care. 2016;39(6):861–77. https://​doi.​org/​10.​2337/​dc16-0236.CrossRefPubMed
13.
go back to reference Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, MM MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1–27. https://doi.org/10.1002/oby.20461.CrossRef Mechanick JI, Youdim A, Jones DB, Garvey WT, Hurley DL, MM MM, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient--2013 update: cosponsored by American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery. Obesity (Silver Spring). 2013;21(Suppl 1):S1–27. https://​doi.​org/​10.​1002/​oby.​20461.CrossRef
18.
go back to reference Fielding GA, Allen JW. A step-by-step guide to placement of the LAP-BAND adjustable gastric banding system. Am J Surg. 2002;184(6B):26S–30S.CrossRefPubMed Fielding GA, Allen JW. A step-by-step guide to placement of the LAP-BAND adjustable gastric banding system. Am J Surg. 2002;184(6B):26S–30S.CrossRefPubMed
27.
go back to reference •• Adams TD, Davidson LE, Litwin SE, Kim J, Kolotkin RL, Nanjee MN, et al. Weight and metabolic outcomes 12 years after gastric bypass. N Engl J Med. 2017;377(12):1143–55. https://doi.org/10.1056/NEJMoa1700459. This study demonstrates one of the longest follow-up periods, 12 years, for patients undergoing metabolic surgery. It demonstrates the long-term efficacy of metabolic surgery in achieving weight loss and decrease in obesity-associated comorbidities. CrossRefPubMedPubMedCentral •• Adams TD, Davidson LE, Litwin SE, Kim J, Kolotkin RL, Nanjee MN, et al. Weight and metabolic outcomes 12 years after gastric bypass. N Engl J Med. 2017;377(12):1143–55. https://​doi.​org/​10.​1056/​NEJMoa1700459. This study demonstrates one of the longest follow-up periods, 12 years, for patients undergoing metabolic surgery. It demonstrates the long-term efficacy of metabolic surgery in achieving weight loss and decrease in obesity-associated comorbidities. CrossRefPubMedPubMedCentral
30.
go back to reference Wendling MR, Linn JG, Keplinger KM, Mikami DJ, Perry KA, Melvin WS, et al. Omental patch repair effectively treats perforated marginal ulcer following Roux-en-Y gastric bypass. Surg Endosc. 2013;27(2):384–9.CrossRefPubMed Wendling MR, Linn JG, Keplinger KM, Mikami DJ, Perry KA, Melvin WS, et al. Omental patch repair effectively treats perforated marginal ulcer following Roux-en-Y gastric bypass. Surg Endosc. 2013;27(2):384–9.CrossRefPubMed
32.
go back to reference Estimate of bariatric surgery numbers, 2011–2017. American Society for Metabolic and Bariatric Surgery, asmbs.org/resources/estimate-of-bariatric-surgery-numbers. Estimate of bariatric surgery numbers, 2011–2017. American Society for Metabolic and Bariatric Surgery, asmbs.org/resources/estimate-of-bariatric-surgery-numbers.
34.
go back to reference Yousseif A, Emmanuel J, Karra E, Millet Q, Elkalaawy M, Jenkinson AD, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg. 2014;24(2):241–52. https://doi.org/10.1007/s11695-013-1066-0.CrossRefPubMed Yousseif A, Emmanuel J, Karra E, Millet Q, Elkalaawy M, Jenkinson AD, et al. Differential effects of laparoscopic sleeve gastrectomy and laparoscopic gastric bypass on appetite, circulating acyl-ghrelin, peptide YY3-36 and active GLP-1 levels in non-diabetic humans. Obes Surg. 2014;24(2):241–52. https://​doi.​org/​10.​1007/​s11695-013-1066-0.CrossRefPubMed
36.
go back to reference Kim M, Navarro F, Eruchalu CN, Augenstein VA, Heniford BT, Stefanidis D. Minimally invasive Roux-en-Y gastric bypass for fundoplication failure offers excellent gastroesophageal reflux control. Am Surg. 2014;80(7):696–703.PubMed Kim M, Navarro F, Eruchalu CN, Augenstein VA, Heniford BT, Stefanidis D. Minimally invasive Roux-en-Y gastric bypass for fundoplication failure offers excellent gastroesophageal reflux control. Am Surg. 2014;80(7):696–703.PubMed
38.
go back to reference •• Peterli R, Wölnerhanssen BK, Vetter D, Nett P, Gass M, Borbély Y, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS). Ann Surg. 2017;265(3):466–73. https://doi.org/10.1097/SLA.0000000000001929. A randomized controlled trial comparing RYGB and SG over a 3 year period. CrossRefPubMed •• Peterli R, Wölnerhanssen BK, Vetter D, Nett P, Gass M, Borbély Y, et al. Laparoscopic sleeve gastrectomy versus Roux-Y-gastric bypass for morbid obesity-3-year outcomes of the prospective randomized Swiss Multicenter Bypass Or Sleeve Study (SM-BOSS). Ann Surg. 2017;265(3):466–73. https://​doi.​org/​10.​1097/​SLA.​0000000000001929​. A randomized controlled trial comparing RYGB and SG over a 3 year period. CrossRefPubMed
45.
go back to reference •• Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS Randomized Clinical Trial. JAMA. 2018;319(3):241–54. https://doi.org/10.1001/jama.2017.20313. A randomized controlled trial comparing SG and RYGB over a 5-year period. CrossRefPubMedPubMedCentral •• Salminen P, Helmiö M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, et al. Effect of laparoscopic sleeve gastrectomy vs laparoscopic Roux-en-Y gastric bypass on weight loss at 5 years among patients with morbid obesity: the SLEEVEPASS Randomized Clinical Trial. JAMA. 2018;319(3):241–54. https://​doi.​org/​10.​1001/​jama.​2017.​20313. A randomized controlled trial comparing SG and RYGB over a 5-year period. CrossRefPubMedPubMedCentral
46.
Metadata
Title
Metabolic Surgery as a Treatment Option for Type 2 Diabetes Mellitus: Surgical View
Authors
Eric Rachlin
Carlos Galvani
Publication date
01-11-2018
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 11/2018
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-018-1094-1

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