Obesity, type 2 diabetes and the metabolic syndrome: pathophysiologic relationships and guidelines for surgical intervention
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Authors
Genser, Laurent
Casella Mariolo, James Rossario
Castagneto-Gissey, Lidia
Panagiotopoulos, Spyros
Rubino, Francesco
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Issue Date
2016
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Article
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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.
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Journal
Surgical Clinics of North America
Volume
96
Issue
4