Bariatric Surgery as a Long-Term Treatment for Type 2 Diabetes/Metabolic Syndrome

Annu Rev Med. 2020 Jan 27:71:1-15. doi: 10.1146/annurev-med-053117-123246.

Abstract

Metabolic surgery is increasingly becoming recognized as a more effective treatment for patients with type 2 diabetes (T2D) and obesity as compared to lifestyle modification and medical management alone. Both observational studies and clinical trials have shown metabolic surgery to result in sustained weight loss (20-30%), T2D remission rates ranging from 23% to 60%, and improvement in cardiovascular risk factors such as hypertension and dyslipidemia. Metabolic surgery is cost-effective and relatively safe, with perioperative risks and mortality comparable to low-risk procedures such as cholecystectomy, hysterectomy, and appendectomy. International diabetes and medical organizations have endorsed metabolic surgery as a standard treatment for T2D with obesity.

Keywords: bariatric surgery; cardiovascular risk factor; diabetes remission; metabolic surgery; type 2 diabetes; weight loss.

Publication types

  • Review

MeSH terms

  • Bariatric Surgery / methods*
  • Cardiovascular Diseases / epidemiology
  • Cost-Benefit Analysis
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetes Mellitus, Type 2 / surgery*
  • Diet, Reducing
  • Dyslipidemias / complications
  • Dyslipidemias / metabolism
  • Exercise
  • Humans
  • Hypertension / complications
  • Hypoglycemic Agents / therapeutic use
  • Life Style
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / metabolism
  • Metabolic Syndrome / surgery*
  • Obesity / complications
  • Obesity / surgery*
  • Patient Selection
  • Postoperative Complications / epidemiology
  • Risk Reduction Behavior
  • Treatment Outcome

Substances

  • Hypoglycemic Agents