Obesity, Type 2 Diabetes, and the Metabolic Syndrome: Pathophysiologic Relationships and Guidelines for Surgical Intervention

Surg Clin North Am. 2016 Aug;96(4):681-701. doi: 10.1016/j.suc.2016.03.013.

Abstract

Several gastrointestinal (GI) operations originally developed for the treatment of severe obesity (bariatric surgery) promote sustained weight loss as well as dramatic, durable improvements of insulin-resistant states, most notably type 2 diabetes mellitus (T2DM). Experimental evidence shows that some rearrangements of GI anatomy can directly affect glucose homeostasis, insulin sensitivity, and inflammation, supporting the idea that the GI tract is a biologically rational target for interventions aimed at correcting pathophysiologic aspects of cardiometabolic disorders. This article reviews the pathophysiology of metabolic disease and the role of bariatric/metabolic surgery in current clinical guidelines for the treatment of obesity and T2DM.

Keywords: Bariatric metabolic surgery; Diabetes; Gut; Insulin resistance; Metabolic syndrome; Microbiota; Obesity.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Diabetes Mellitus, Type 2 / surgery*
  • Humans
  • Metabolic Syndrome / physiopathology
  • Metabolic Syndrome / surgery*
  • Obesity / physiopathology
  • Obesity / surgery*
  • Practice Guidelines as Topic
  • Treatment Outcome