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Bariatric/metabolic surgery and its role in the treatment of type 2 diabetes mellitus


Authors: E. Konečná;  E. Šimůnková;  K. Šuta-Kimle;  D. Michalský
Authors‘ workplace: Přednosta: prof. MUDr. Zdeněk Krška, DrSc. ;  I. chirurgická klinika 1. LF UK a VFN, Praha
Published in: Prakt. Lék. 2019; 99(6): 245-252
Category: Reviews

Overview

Bariatric surgeries, originally designed exclusively to achieve weight loss in morbidly obese patients, have also been unequivocally proven as having additional positive impacts on patients’ glycaemic profiles and limiting metabolic comorbidities. Based on these findings, metabolic surgery became a term for procedures not aimed to achieve weight loss as a primary outcome, but rather to help treat type 2 diabetes mellitus and other metabolic diseases tied to obesity. In light of the fact that both bariatric and metabolic effects are observed after a procedure, we prefer to call these procedures more aptly bariatric/metabolic surgery. Based on randomized studies, we confirmed higher efficacy of metabolic surgery for improving glycaemic profiles for patients in comparison to conservative approaches (i.e., lifestyle changes, diet regimes, or taking medicaments). These novel results place bariatric/metabolic surgery among standard procedures to treat type 2 diabetes mellitus. Additionally, our findings suggest lowering a current BMI recommendation threshold for a procedure for individuals with 35 BMI (kg/m2) down to 30 BMI (kg/m2).

Keywords:

metabolic surgery – obesity – bariatric surgery – type 2 diabetes mellitus


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