Role Of Bariatric Surgery In Type 2 Diabetes
Abstract
The obesity pandemic resulted in an exponential rise in the incidence and prevalence of type 2 diabetes mellitus (T2 DM) globally. T2 DM as a consequence of obesity – the diabesity – is a difficult clinical problem faced by physicians with limited medical management options. Bariatric surgery or metabolic surgery has emerged as a promising treatment option in patients with diabesity that results in marked weight loss and remission of T2 DM. Although invasive, costly and associated with complications in a minor proportion of patients, bariatric surgery is recommended as an important management option for severely obese individuals with or without diabesity by many professional bodies globally. This review discusses the important types, benefits, indications and complications of bariatric surgery in patients with diabesity with an up to date scientific evidence.References
1. International Diabetes Federation. IDF Diabetes Atlas - 7th Edition [Assessed on 2016 October 16] Available from: http://www.diabetesatlas.org/key-messages.html
2. Sims EA, Danforth E Jr, Horton ES, Bray GA, Glennon JA, Salans LB. Endocrine and metabolic effects of experimental obesity in man. Recent Prog Horm Res. 1973; 29: 457-96.Â
3. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, Castagneto M, Bornstein S, Rubino F. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2diabetes: 5-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015; 386(9997): 964-73.
4. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ES, Nissen SE, Kashyap SR; STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes-3-year outcomes. N Engl J Med. 2014; 370: 2002-13.
5. Li J, Lai D, Wu D. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy to Treat Morbid Obesity-Related Comorbidities: a Systematic Review and Meta-analysis. Obes Surg. 2016; 26: 429-42.
6. Baskota A, Li S, Dhakal N, Liu G, Tian H. Bariatric Surgery for Type 2 Diabetes Mellitus in Patients with BMI <30 kg/m2: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10: e0132335.
7. Pappachan JM, Viswanath AK. Metabolic surgery: A paradigm shift in type 2 diabetes management. World J Diabetes. 2015; 6: 990-8.
8. Azagury DE, Morton JM. Bariatric Surgery: Overview of Procedures and Outcomes. Endocrinol Metab Clin North Am. 2016; 45: 647-56.
9. Wang S, Li P, Sun XF, Ye NY, Xu ZK, Wang D. Comparison between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding for morbid obesity: a meta-analysis. Obes Surg. 2013; 23: 980-6.
10. Paulus GF, de Vaan LE, Verdam FJ, Bouvy ND, Ambergen TA, van Heurn LW. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015; 25: 860-78.
11. Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lönroth H, Näslund I, Olbers T, Stenlöf K, Torgerson J, Agren G, Carlsson LM; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357: 741-52.
12. Yska JP, van Roon EN, de Boer A, Leufkens HG, Wilffert B, de Heide LJ, de Vries F, Lalmohamed A. Remission of Type 2 Diabetes Mellitus in Patients After Different Types of Bariatric Surgery: A Population-Based Cohort Study in the United Kingdom. JAMA Surg. 2015; 150: 1126-33.
13. Paulus GF, de Vaan LE, Verdam FJ, Bouvy ND, Ambergen TA, van Heurn LW. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015; 25: 860-78.
14. Yu J, Zhou X, Li L, Li S, Tan J, Li Y, Sun X. The long-term effects of bariatric surgery for type 2 diabetes: systematic review and meta-analysis of randomized and non-randomized evidence. Obes Surg. 2015; 25: 143-58.
15. Gaur A, Naidu CS, Rao PP, Sharma S, Singh AK, Trehan V, Kulkarni SV, Pathak N, Singh A, Goyal B. The effect of laparoscopic sleeve gastrectomy (LSG) on glycemic control in morbidly obese patients. Int J Surg. 2016; 28: 131-5.
16. de Hollanda A, Casals G, Delgado S, Jiménez A, Viaplana J, Lacy AM, Vidal J. Gastrointestinal Hormones and Weight Loss Maintenance Following Roux-en-Y Gastric Bypass. J Clin Endocrinol Metab. 2015; 100: 4677-84.
17. Tang Q, Sun Z, Zhang N, Xu G, Song P, Xu L, Tang W. Cost-Effectiveness of Bariatric Surgery for Type 2 Diabetes Mellitus: A Randomized Controlled Trial in China. Medicine (Baltimore). 2016; 95: e3522.
18. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, Harmon CM, Zeller MH, Chen MK, Xanthakos SA, Horlick M, Buncher CR; Teen-LABS Consortium. Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents. N Engl J Med. 2016; 374: 113-23.
19. Panunzi S, De Gaetano A, Carnicelli A, Mingrone G. Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatricsurgery: do BMI or procedure choice matter? AÂ meta-analysis. Ann Surg. 2015; 261: 459-67.
20. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014; 149: 275-87.
21. Pontiroli AE, Morabito A. Long-term prevention of mortality in morbid obesity through bariatric surgery. a systematic review and meta-analysis of trials performed with gastric banding and gastric bypass. Ann Surg. 2011; 253: 484-7.
22. Kwok CS, Pradhan A, Khan MA, Anderson SG, Keavney BD, Myint PK, Mamas MA, Loke YK. Bariatric surgery and its impact on cardiovascular disease and mortality: a systematic review and meta-analysis. Int J Cardiol. 2014; 173: 20-8.
23. Panunzi S, De Gaetano A, Carnicelli A, Mingrone G. Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatric surgery: do BMI or procedure choice matter? AÂ meta-analysis. Ann Surg. 2015; 261: 459-67.
24. O'Kane M, Barth JH. Nutritional follow-up of patients after obesity surgery: best practice. Clin Endocrinol (Oxf). 2016; 84: 658-61.
25. Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ. 2014; 349: g3961.
26. Iannelli A, Schneck AS, Hébuterne X, Gugenheim J. Gastric pouch resizing for Roux-en-Y gastric bypass failure in patients with a dilated pouch. Surg Obes Relat Dis. 2013; 9: 260-7.
27. Boules M, Chang J, Haskins IN, Sharma G, Froylich D, El-Hayek K, Rodriguez J, Kroh M. Endoscopic management of post-bariatric surgery complications. World J Gastrointest Endosc. 2016; 8: 591-9.
28. Fringeli Y, Worreth M, Langer I. Gastrojejunal Anastomosis Complications and Their Management after Laparoscopic Roux-en-Y Gastric Bypass. J Obes. 2015; 2015: 698425.Â
29. Stegenga H, Haines A, Jones K, Wilding J; Guideline Development Group. Identification, assessment, and management of overweight and obesity: summary of updated NICE guidance. BMJ. 2014; 349: g6608.
30. Picot J, Jones J, Colquitt JL, Loveman E, Clegg AJ. Weight loss surgery for mild to moderate obesity: a systematic review and economic evaluation. Obes Surg. 2012; 22: 1496-506.
31. Tadross JA, le Roux CW. The mechanisms of weight loss after bariatric surgery. Int J Obes (London) 2009; 33 (Suppl 1): S28–S32.
32. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007; 357: 753-61.
33. Davidson LE, Adams TD, Kim J, Jones JL, Hashibe M, Taylor D, Mehta T, McKinlay R, Simper SC, Smith SC, Hunt SC. Association of Patient Age at Gastric Bypass Surgery With Long-term All-Cause and Cause-Specific Mortality. JAMA Surg. 2016; 151: 631-7.
34. Arterburn DE, Olsen MK, Smith VA, Livingston EH, Van Scoyoc L, Yancy WS Jr, Eid G, Weidenbacher H, Maciejewski ML. Association between bariatric surgery and long-term survival. JAMA. 2015; 313: 62-70.
35. Müller-Stich BP, Senft JD, Warschkow R, Kenngott HG, Billeter AT, Vit G, Helfert S, Diener MK, Fischer L, Büchler MW, Nawroth PP. Surgical versus medical treatment of type 2 diabetes mellitus in nonseverely obese patients: a systematic review and meta-analysis. Ann Surg. 2015; 261: 421-9.
36. Johansson K, Cnattingius S, Näslund I, Roos N, Trolle Lagerros Y, Granath F, Stephansson O, Neovius M. Outcomes of pregnancy after bariatric surgery. N Engl J Med. 2015; 372: 814-24.
2. Sims EA, Danforth E Jr, Horton ES, Bray GA, Glennon JA, Salans LB. Endocrine and metabolic effects of experimental obesity in man. Recent Prog Horm Res. 1973; 29: 457-96.Â
3. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Nanni G, Castagneto M, Bornstein S, Rubino F. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2diabetes: 5-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015; 386(9997): 964-73.
4. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, Aminian A, Pothier CE, Kim ES, Nissen SE, Kashyap SR; STAMPEDE Investigators. Bariatric surgery versus intensive medical therapy for diabetes-3-year outcomes. N Engl J Med. 2014; 370: 2002-13.
5. Li J, Lai D, Wu D. Laparoscopic Roux-en-Y Gastric Bypass Versus Laparoscopic Sleeve Gastrectomy to Treat Morbid Obesity-Related Comorbidities: a Systematic Review and Meta-analysis. Obes Surg. 2016; 26: 429-42.
6. Baskota A, Li S, Dhakal N, Liu G, Tian H. Bariatric Surgery for Type 2 Diabetes Mellitus in Patients with BMI <30 kg/m2: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10: e0132335.
7. Pappachan JM, Viswanath AK. Metabolic surgery: A paradigm shift in type 2 diabetes management. World J Diabetes. 2015; 6: 990-8.
8. Azagury DE, Morton JM. Bariatric Surgery: Overview of Procedures and Outcomes. Endocrinol Metab Clin North Am. 2016; 45: 647-56.
9. Wang S, Li P, Sun XF, Ye NY, Xu ZK, Wang D. Comparison between laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding for morbid obesity: a meta-analysis. Obes Surg. 2013; 23: 980-6.
10. Paulus GF, de Vaan LE, Verdam FJ, Bouvy ND, Ambergen TA, van Heurn LW. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015; 25: 860-78.
11. Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, Lystig T, Sullivan M, Bouchard C, Carlsson B, Bengtsson C, Dahlgren S, Gummesson A, Jacobson P, Karlsson J, Lindroos AK, Lönroth H, Näslund I, Olbers T, Stenlöf K, Torgerson J, Agren G, Carlsson LM; Swedish Obese Subjects Study. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007; 357: 741-52.
12. Yska JP, van Roon EN, de Boer A, Leufkens HG, Wilffert B, de Heide LJ, de Vries F, Lalmohamed A. Remission of Type 2 Diabetes Mellitus in Patients After Different Types of Bariatric Surgery: A Population-Based Cohort Study in the United Kingdom. JAMA Surg. 2015; 150: 1126-33.
13. Paulus GF, de Vaan LE, Verdam FJ, Bouvy ND, Ambergen TA, van Heurn LW. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes Surg. 2015; 25: 860-78.
14. Yu J, Zhou X, Li L, Li S, Tan J, Li Y, Sun X. The long-term effects of bariatric surgery for type 2 diabetes: systematic review and meta-analysis of randomized and non-randomized evidence. Obes Surg. 2015; 25: 143-58.
15. Gaur A, Naidu CS, Rao PP, Sharma S, Singh AK, Trehan V, Kulkarni SV, Pathak N, Singh A, Goyal B. The effect of laparoscopic sleeve gastrectomy (LSG) on glycemic control in morbidly obese patients. Int J Surg. 2016; 28: 131-5.
16. de Hollanda A, Casals G, Delgado S, Jiménez A, Viaplana J, Lacy AM, Vidal J. Gastrointestinal Hormones and Weight Loss Maintenance Following Roux-en-Y Gastric Bypass. J Clin Endocrinol Metab. 2015; 100: 4677-84.
17. Tang Q, Sun Z, Zhang N, Xu G, Song P, Xu L, Tang W. Cost-Effectiveness of Bariatric Surgery for Type 2 Diabetes Mellitus: A Randomized Controlled Trial in China. Medicine (Baltimore). 2016; 95: e3522.
18. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, Harmon CM, Zeller MH, Chen MK, Xanthakos SA, Horlick M, Buncher CR; Teen-LABS Consortium. Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents. N Engl J Med. 2016; 374: 113-23.
19. Panunzi S, De Gaetano A, Carnicelli A, Mingrone G. Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatricsurgery: do BMI or procedure choice matter? AÂ meta-analysis. Ann Surg. 2015; 261: 459-67.
20. Chang SH, Stoll CR, Song J, Varela JE, Eagon CJ, Colditz GA. The effectiveness and risks of bariatric surgery: an updated systematic review and meta-analysis, 2003-2012. JAMA Surg. 2014; 149: 275-87.
21. Pontiroli AE, Morabito A. Long-term prevention of mortality in morbid obesity through bariatric surgery. a systematic review and meta-analysis of trials performed with gastric banding and gastric bypass. Ann Surg. 2011; 253: 484-7.
22. Kwok CS, Pradhan A, Khan MA, Anderson SG, Keavney BD, Myint PK, Mamas MA, Loke YK. Bariatric surgery and its impact on cardiovascular disease and mortality: a systematic review and meta-analysis. Int J Cardiol. 2014; 173: 20-8.
23. Panunzi S, De Gaetano A, Carnicelli A, Mingrone G. Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatric surgery: do BMI or procedure choice matter? AÂ meta-analysis. Ann Surg. 2015; 261: 459-67.
24. O'Kane M, Barth JH. Nutritional follow-up of patients after obesity surgery: best practice. Clin Endocrinol (Oxf). 2016; 84: 658-61.
25. Arterburn DE, Courcoulas AP. Bariatric surgery for obesity and metabolic conditions in adults. BMJ. 2014; 349: g3961.
26. Iannelli A, Schneck AS, Hébuterne X, Gugenheim J. Gastric pouch resizing for Roux-en-Y gastric bypass failure in patients with a dilated pouch. Surg Obes Relat Dis. 2013; 9: 260-7.
27. Boules M, Chang J, Haskins IN, Sharma G, Froylich D, El-Hayek K, Rodriguez J, Kroh M. Endoscopic management of post-bariatric surgery complications. World J Gastrointest Endosc. 2016; 8: 591-9.
28. Fringeli Y, Worreth M, Langer I. Gastrojejunal Anastomosis Complications and Their Management after Laparoscopic Roux-en-Y Gastric Bypass. J Obes. 2015; 2015: 698425.Â
29. Stegenga H, Haines A, Jones K, Wilding J; Guideline Development Group. Identification, assessment, and management of overweight and obesity: summary of updated NICE guidance. BMJ. 2014; 349: g6608.
30. Picot J, Jones J, Colquitt JL, Loveman E, Clegg AJ. Weight loss surgery for mild to moderate obesity: a systematic review and economic evaluation. Obes Surg. 2012; 22: 1496-506.
31. Tadross JA, le Roux CW. The mechanisms of weight loss after bariatric surgery. Int J Obes (London) 2009; 33 (Suppl 1): S28–S32.
32. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, Lamonte MJ, Stroup AM, Hunt SC. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007; 357: 753-61.
33. Davidson LE, Adams TD, Kim J, Jones JL, Hashibe M, Taylor D, Mehta T, McKinlay R, Simper SC, Smith SC, Hunt SC. Association of Patient Age at Gastric Bypass Surgery With Long-term All-Cause and Cause-Specific Mortality. JAMA Surg. 2016; 151: 631-7.
34. Arterburn DE, Olsen MK, Smith VA, Livingston EH, Van Scoyoc L, Yancy WS Jr, Eid G, Weidenbacher H, Maciejewski ML. Association between bariatric surgery and long-term survival. JAMA. 2015; 313: 62-70.
35. Müller-Stich BP, Senft JD, Warschkow R, Kenngott HG, Billeter AT, Vit G, Helfert S, Diener MK, Fischer L, Büchler MW, Nawroth PP. Surgical versus medical treatment of type 2 diabetes mellitus in nonseverely obese patients: a systematic review and meta-analysis. Ann Surg. 2015; 261: 421-9.
36. Johansson K, Cnattingius S, Näslund I, Roos N, Trolle Lagerros Y, Granath F, Stephansson O, Neovius M. Outcomes of pregnancy after bariatric surgery. N Engl J Med. 2015; 372: 814-24.
