PMID- 21301486
OWN - NLM
STAT- MEDLINE
DCOM- 20120514
LR  - 20221207
IS  - 1759-5037 (Electronic)
IS  - 1759-5029 (Linking)
VI  - 7
IP  - 7
DP  - 2011 Feb 8
TI  - Type 2 diabetes mellitus--current therapies and the emergence of surgical 
      options.
PG  - 408-19
LID - 10.1038/nrendo.2011.10 [doi]
AB  - Patients with type 2 diabetes mellitus (T2DM) are usually treated with 
      pharmacologic agents in combination with lifestyle modification. The development 
      of new antidiabetic agents, such as insulin analogs and incretin-based therapies, 
      has led to treatment strategies that enable many patients with T2DM to achieve 
      target HbA(1c) levels (</=7.0%). However, many factors-including those related to 
      the patient or the health-care provider, drug inadequacies and adverse 
      effects-can interfere with the ability of some patients to reach metabolic 
      targets. Clinical data from the USA indicate that HbA(1c) concentration, blood 
      pressure and serum levels of lipids in patients with T2DM are progressively 
      decreasing toward the target goals set by the American Diabetes Association. 
      These improvements in metabolic regulation have led to a 30-40% decrease in 
      reported microvascular and macrovascular complications of diabetes mellitus in 
      the USA. Gastric bypass surgery in morbidly obese individuals with T2DM leads to 
      remission of the diabetes mellitus in the majority of patients and improvement in 
      the rest. A major contributor to this improvement is an alteration in 
      gastrointestinal hormone secretions. Interventional surgery might, therefore, be 
      considered a reasonable therapeutic alternative for overweight and obese (BMI <35 
      kg/m(2)) patients with T2DM who do not respond to medical therapy.
FAU - Lebovitz, Harold E
AU  - Lebovitz HE
AD  - State University of New York Health Science Center at Brooklyn, Department of 
      Medicine, Brooklyn, New York, NY 11203, USA. hlebovitz1@hotmail.com
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20110208
PL  - England
TA  - Nat Rev Endocrinol
JT  - Nature reviews. Endocrinology
JID - 101500078
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Animals
MH  - Diabetes Mellitus, Type 2/blood/etiology/*surgery
MH  - Gastric Bypass/*trends
MH  - Glycated Hemoglobin/metabolism
MH  - Humans
MH  - Obesity/blood/complications/surgery
MH  - Randomized Controlled Trials as Topic/trends
MH  - Risk Reduction Behavior
MH  - Treatment Outcome
EDAT- 2011/02/09 06:00
MHDA- 2012/05/15 06:00
CRDT- 2011/02/09 06:00
PHST- 2011/02/09 06:00 [entrez]
PHST- 2011/02/09 06:00 [pubmed]
PHST- 2012/05/15 06:00 [medline]
AID - nrendo.2011.10 [pii]
AID - 10.1038/nrendo.2011.10 [doi]
PST - epublish
SO  - Nat Rev Endocrinol. 2011 Feb 8;7(7):408-19. doi: 10.1038/nrendo.2011.10.