Metabolic surgery – a new approach to the management of selected diseases

Česká verzia

Authors: M. Fried ^1,2 ; K. Doležalová ¹
Authors place of work: Centrum pro léčbu obezity a metabolických poruch OB kliniky Praha, přednosta prof. MUDr. Martin Fried, CSc. ¹; 1. lékařská fakulta UK Praha, děkan prof. MUDr. Tomáš Zima, DrSc., MBA ²
Published in the journal: Vnitř Lék 2011; 57(4): 402-404
Category: 12th national Symposium diabetes, "Diabetes and Gastroenterology", Hradec Kralove, 4 to 5 June 2010

Summary

Treatment options for type 2 diabetes have changed dramatically in the past few years. Experimental works followed by evidence based studies proved long-term efficacy of metabolic surgery in type 2 diabetes treatment. Moreover diabetes resolution is not directly correlated with weight loss and occurs independently to it. Large literature metaanalyses showed that type 2 diabetes can be subtantially improved with metabolic surgery in about 85 % of all diabetic patients, out of which can be resolved in more than 75%. Metabolic surgery affects hormonal secretion on multiple levels namely in the small intestine. Restrictive as well as combined and malabsorptive surgical procedures have positive effect on type 2 diabetes improvement as well as on metabolic syndrome, sleep apnea syndrome and on other comorbidities.

Key words:
metabolic surgery – type 2 diabetes mellitus – surgical treatment of diabetes

Zdroje

1. Buchwald H, Estok R, Fahrbach K et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med 2009; 122: 248–256.

2. Fried M et al. Bariatrická a metabolická chirurgie, nové postupy v léčbě obezity a metabolických poruch. Praha: Mladá Fronta 2011.

3. Scopinaro N, Marinari G, Camerini G et al. 2004 ABS Consensus Conference. Biliopancreatic diversion for obesity: state of the art. Surg Obes Relat Dis 2005; 1: 317–328.

4. Adami GF, Cordera R, Camerini G et al. Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity. Int J Obes Relat Metab Disord 2004; 28: 671–673.

5. Dixon JB, O’Brien PE, Playfair J et al. Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 2008; 299: 316–323.

6. Ponce J, Haynes B, Paynter S et al. Effect of Lap-Band-induced weight loss on type 2 diabetes mellitus and hypertension. Obes Surg 2004; 14: 1335–1342.

7. Schauer PR, Burguera B, Ikramuddin S et al. Effect of laparoscopic Roux-en-Y gastric bypass on type 2 diabetes mellitus. Ann Surg 2003; 238: 467–484.

8. Adami GF, Cordera R, Camerini G et al. Recovery of insulin sensitivity in obese patients at short term after biliopancreatic diversion. J Surg Res 2003; 113: 217–221.

9. Scopinaro N, Adami GF, Papadia FS et al. Effects of Biliopanceratic Diversion on Type 2 Diabetes in Patients With BMI 25 to 35. Ann Surg 2011; 253: 699–703.

10. American Diabetes Association. Standards of Medical Care in Diabetes – 2010. Diabetes Care 2010; 33 (Suppl 1): S11–S61.

11. Buchwald H, Estok R, Fahrbach K et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery 2007; 142: 621–632.