Chapter 18

The Role of Bariatric Surgery in Obese Patients with Diabetes

Primary or Rescue Therapy?

Praveena Gandikota

Praveena Gandikota

Endocrine Fellow, Endocrine, Diabetes and Nutrition Division, Department of Medicine, St Luke's Roosevelt Hospital, New York, NY, USA

Search for more papers by this author
Blandine Laferrère

Blandine Laferrère

Assistant Professor of Medicine, Division of Endocrinology, Diabetes and Nutrition Obesity Research Center Department of Medicine, St Luke's Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY, USA

Search for more papers by this author
First published: 05 November 2021

Summary

Obesity and type 2 diabetes mellitus (T2DM) are major public health issues that are closely related. Lifestyle modifications (LSM) with diet and exercise leading to weight loss are cornerstones of T2DM management along with pharmacologic therapy. Bariatric surgery is increasingly becoming popular for management of morbid obesity and its related comorbidities including T2DM. Weight loss is a key factor in the improvement of T2DM after bariatric surgery. Nearly 30% of patients who undergo bariatric surgery have T2DM, although about a third of these patients are undiagnosed. The percentage of diabetes remission varies according to surgery: 95% after biliopancreatic diversion (BPD)/duodenal switch, 80% after Roux-en-Y gastric bypass (RYGBP), 80% with gastroplasty and 57-73% after gastric banding. Cause-specific mortality in the RYGBP surgery group decreased by 92% for diabetes. Hyperinsulinemic hypoglycemia associated is a relatively uncommon complication of RYGB and has variable severity.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.