PMID- 22176155
OWN - NLM
STAT- MEDLINE
DCOM- 20120709
LR  - 20221207
IS  - 1557-8593 (Electronic)
IS  - 1520-9156 (Linking)
VI  - 14
IP  - 4
DP  - 2012 Apr
TI  - Role of bariatric-metabolic surgery in the treatment of obese type 2 diabetes 
      with body mass index <35 kg/m2: a literature review.
PG  - 365-72
LID - 10.1089/dia.2011.0127 [doi]
AB  - Bariatric surgery has been used to treat type 2 diabetes mellitus (T2DM); 
      however, its efficacy is still debatable. This literature review analyzed 
      articles that evaluated the effects of bariatric surgery in treatment of T2DM in 
      obese patients with a body mass index (BMI) of <35 kg/m(2). A paired t test was 
      applied for the analysis of pre- and postintervention mean BMI, fasting plasma 
      glucose (FPG), and glycosylated hemoglobin (A1c) values. A significant (P<0.001) 
      reduction in BMI (from 29.95+/-0.51 kg/m(2) to 24.83+/-0.44 kg/m(2)), FPG (from 
      207.86+/-8.51 mg/dL to 113.54+/-4.93 mg/dL), and A1c (from 8.89+/-0.15% to 6.35+/-0.18%) 
      was observed in 29 articles (n=675). T2DM resolution (A1c <7% without 
      antidiabetes medication) was achieved in 84.0% (n=567) of the subjects. T2DM 
      remission, control, and improvement were observed in 55.41%, 28.59%, and 14.37%, 
      respectively. Only 1.63% (n=11) of the subjects presented similar or worse 
      glycemic control after the surgery. T2DM remission (A1c <6% without antidiabetes 
      medication) was higher after mini-gastric bypass (72.22%) and 
      laparoscopic/Roux-en-Y gastric bypass (70.43%). According to the Foregut and 
      Hindgut Hypotheses, T2DM results from the imbalance between the incretins and 
      diabetogenic signals. The procedures that remove the proximal intestine and do 
      ileal transposition contribute to the increase of glucagon-like peptide-1 levels 
      and improvement of insulin sensitivity. These findings provide preliminary 
      evidence of the benefits of bariatric-metabolic surgery on glycemic control of 
      T2DM obese subjects with a BMI of <35 kg/m(2). However, more clinical trials are 
      needed to investigate the metabolic effects of bariatric surgery in T2DM 
      remission on pre-obese and obese class I patients.
FAU - Reis, Caio E G
AU  - Reis CE
AD  - School of Health Sciences, University of Brasilia, Brasilia, Brazil. 
      caioedureis@gmail.com
FAU - Alvarez-Leite, Jacqueline I
AU  - Alvarez-Leite JI
FAU - Bressan, Josefina
AU  - Bressan J
FAU - Alfenas, Rita C
AU  - Alfenas RC
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20111216
PL  - United States
TA  - Diabetes Technol Ther
JT  - Diabetes technology & therapeutics
JID - 100889084
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 0 (Glycated Hemoglobin A)
RN  - 0 (hemoglobin A1c protein, human)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/blood
MH  - Blood Glucose/*metabolism
MH  - *Body Mass Index
MH  - Female
MH  - Gastric Bypass/adverse effects/*methods
MH  - Glycated Hemoglobin/*metabolism
MH  - Guidelines as Topic
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Obesity, Morbid/*blood/physiopathology/*surgery
MH  - Postoperative Complications/*blood/physiopathology
MH  - Treatment Outcome
MH  - Weight Loss
MH  - Young Adult
EDAT- 2011/12/20 06:00
MHDA- 2012/07/10 06:00
CRDT- 2011/12/20 06:00
PHST- 2011/12/20 06:00 [entrez]
PHST- 2011/12/20 06:00 [pubmed]
PHST- 2012/07/10 06:00 [medline]
AID - 10.1089/dia.2011.0127 [doi]
PST - ppublish
SO  - Diabetes Technol Ther. 2012 Apr;14(4):365-72. doi: 10.1089/dia.2011.0127. Epub 
      2011 Dec 16.