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Current Diabetes Reports
Published in: Current Diabetes Reports 12/2019

01-12-2019 | Obesity | Therapies and New Technologies in the Treatment of Diabetes (M Pietropaolo, Section Editor)

Bariatric Surgery in the Treatment of Type 2 Diabetes

Authors: Alison H. Affinati, Nazanene H. Esfandiari, Elif A. Oral, Andrew T. Kraftson

Published in: Current Diabetes Reports | Issue 12/2019

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Abstract

Purpose of Review

We seek to characterize the impact of bariatric surgery on diabetes mellitus by recalling its history, examining the clinical data, exploring the putative mechanisms of action, and anticipating its future.

Recent Findings

Results of clinical trials reveal that bariatric surgery induces remission of diabetes in 33–90% of individuals at 1-year post-treatment versus 0–39% of medically managed. Remission rates decrease over time but remain higher in surgically treated individuals. Investigations have revealed numerous actions of surgery including effects on intestinal physiology, neuronal signaling, incretin hormone secretion, bile acid metabolism, and microbiome changes.

Summary

Bariatric surgery improves control of diabetes through both weight-dependent and weight-independent actions. These various mechanisms help explain the difference between individuals treated surgically vs. medically. They also explain differing effects of various bariatric surgery procedure types. Understanding how surgery affects diabetes will help optimize utilization of the therapy for both disease prevention and treatment.
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Metadata
Title
Bariatric Surgery in the Treatment of Type 2 Diabetes
Authors
Alison H. Affinati
Nazanene H. Esfandiari
Elif A. Oral
Andrew T. Kraftson
Publication date
01-12-2019
Publisher
Springer US
Published in
Current Diabetes Reports / Issue 12/2019
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI
https://doi.org/10.1007/s11892-019-1269-4

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WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

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