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Metabolic surgery for the treatment of type 2 diabetes in obese individuals
Open accessAbstract
Several bariatric operations originally designed to promote weight loss have been found to powerfully treat type 2 diabetes, causing remission in most cases, through diverse mechanisms additional to the secondary consequences of weight loss. These observations have prompted consideration of such operations as ‘metabolic surgery’, used expressly to treat diabetes, including among patients who are only mildly obese or merely overweight. Large, long-term observational studies consistently demonstrate that bariatric/metabolic surgery is associated with reductions in all cardiovascular risk factors, actual cardiovascular events, microvascular diabetes complications, cancer and death. Numerous recent randomised clinical trials, directly comparing various surgical vs non-surgical interventions for diabetes, uniformly demonstrate the former to be superior for improvements in all glycaemic variables, as well as other metabolic endpoints. These benefits are similar among individuals with type 2 diabetes and a preoperative BMI of 30–35 kg/m 2 compared with traditional bariatric surgery patients with a BMI >35 kg/m 2 . The safety profiles of modern laparoscopic bariatric/metabolic operations are similar to those of elective laparoscopic hysterectomy and knee arthroplasty. However, more evidence regarding the risks, benefits and costs of surgery is needed from very long-term (>5 year) randomised clinical trials powered to observe ‘hard’ clinical endpoints following the operations most commonly used today. Given the efficacy, safety and cost-effectiveness of metabolic surgery, the second Diabetes Surgery Summit (DSS-II) consensus conference recently placed surgery squarely within the overall diabetes treatment algorithm, recommending consideration of this approach for patients with inadequately controlled diabetes and a BMI as low as 30 kg/m 2 , or 27.5 kg/m 2 for Asian individuals. These new guidelines have been formally ratified by 53 leading diabetes and surgery societies worldwide. Given this broad level of endorsement, we feel that the DSS-II recommendations should now replace the outdated National Institutes of Health (NIH) suggestions that have governed bariatric surgery practice and insurance compensation worldwide since 1991.
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Surgical interventions elicit numerous metabolic effects opposite to the compensatory physiologic responses normally triggered by diet-induced weight reduction, thereby promoting major, long-term weight loss.
“However, evidence demonstrates that surgical interventions elicit numerous metabolic effects opposite to the compensatory physiologic responses normally triggered by diet-induced weight reduction, thereby promoting major, long-term weight loss99.”
From Joint international consensus statement for ending stigma of obesity (2020) · cites this paper as [99]
The Clinical rationale section reports greater improvements in body weight after surgery than with non-surgical care, including in long-term observational studies. The Biological rationale section discusses weight-independent glucose-lowering mechanisms, but does not say that surgery reverses the compensatory physiological responses to diet-induced weight loss or that those effects cause sustained weight loss. Page numbers were not available in our copy. (LLM, conf=0.85)
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10-year follow-up of intensive glucose control in type 2 diabetes
Holman, R. R., Paul, S. K., Bethel, M. A., Matthews, D. R., & Neil, H. A. W. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0806470 · Cited by 7,751
Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes
(2005) · New England Journal of Medicine · doi:10.1056/nejmoa052187 · Cited by 5,138
Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects
Sjöström, L., Narbro, K., Sjöström, C. D., Karason, K., Larsson, B., Wedel, H., Lystig, T., Sullivan, M., Bouchard, C., Carlsson, B., et al. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa066254 · Cited by 4,668
Long-term mortality after gastric bypass surgery
Adams, T. D., Gress, R. E., Smith, S. C., Halverson, R. C., Simper, S. C., Rosamond, W. D., LaMonte, M. J., Stroup, A. M., & Hunt, S. C. (2007) · New England Journal of Medicine · doi:10.1056/nejmoa066603 · Cited by 2,572
Perioperative safety in the longitudinal assessment of bariatric surgery
(2009) · New England Journal of Medicine · doi:10.1056/nejmoa0901836 · Cited by 1,392
Picot, J., Jones, J., Colquitt, J., Gospodarevskaya, E., Loveman, E., Baxter, L., & Clegg, A. (2009) · Health Technology Assessment · doi:10.3310/hta13410 · Cited by 1,066
Achievement of Goals in U.S. Diabetes Care, 1999–2010
Ali, M. K., Bullard, K. M., Saaddine, J. B., Cowie, C. C., Imperatore, G., & Gregg, E. W. (2013) · New England Journal of Medicine · doi:10.1056/nejmsa1213829 · Cited by 979
Mechanisms of diabetes improvement following bariatric/metabolic surgery
Batterham, R. L., & Cummings, D. E. (2016) · Diabetes Care · doi:10.2337/dc16-0145 · Cited by 376
Self-citationRubino, F., Kaplan, L. M., Schauer, P. R., & Cummings, D. E. (2010) · Annals of Surgery · doi:10.1097/sla.0b013e3181be34e7 · Cited by 325
Self-citationSchauer, P. R., Mingrone, G., Ikramuddin, S., & Wolfe, B. (2016) · Diabetes Care · doi:10.2337/dc16-0382 · Cited by 215
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Research works printed but not linked: 19
- Rubino F, Nathan DM, Eckel RH et al (2016) Metabolic surgery in the treatment algorithm for type 2 diabetes: a joint statement by international diabetes organizations. Diabetes Care 39:861–877 · DOI · Paper page
- American Diabetes Association (2017) Obesity management for the treatment of type 2 diabetes. Diabetes Care 40:S57–S63 · DOI
- Arterburn D, Bogart A, Sherwood N et al (2013) A multisite study of long-term remission and relapse of type 2 diabetes mellitus following gastric bypass. Obes Surg 23:93–102 · DOI · Paper page
- Sjostrom L (2013) Review of the key results from the Swedish Obese Subjects (SOS) trial - a prospective controlled intervention study of bariatric surgery. J Intern Med 273:219–234 · DOI · Paper page
- Adams TD, Davidson LE, Litwin SE et al (2012) Health benefits of gastric bypass surgery after 6 years. JAMA 308:1122–1131 · DOI · Paper page
- Arterburn DE, Olsen MK, Smith VA et al (2015) Association between bariatric surgery and long-term survival. JAMA 313:62–70 · DOI · Paper page
- Adams TD, Arterburn DE, Nathan DM, Eckel RH (2016) Clinical outcomes of metabolic surgery: microvascular and macrovasular complications. Diabetes Care 39:912–923 · DOI
- Thaler JP, Cummings DE (2009) Hormonal and metabolic mechanisms of diabetes remission after gastrointestinal surgery. Endocrinology 150:2518–2525 · DOI · Paper page
- Cummings DE, Cohen RV (2016) Bariatric/metabolic surgery to treat type 2 diabetes in patients with a BMI <35 kg/m2. Diabetes Care 39:924–933 · DOI
- Cummings DE, Cohen RV (2014) Beyond BMI: the need for new guidelines governing the use of bariatric and metabolic surgery. Lancet Diabetes Endocrinol 2:175–181 · DOI
- Vest AR, Heneghan HM, Agarwal S, Schauer PR, Young JB (2012) Bariatric surgery and cardiovascular outcomes: a systematic review. Heart 98:1763–1777 · DOI · Paper page
- Panunzi S, De Gaetano A, Carnicelli A, Mingrone G (2015) Predictors of remission of diabetes mellitus in severely obese individuals undergoing bariatric surgery: do BMI or procedure choice matter? A meta-analysis. Ann Surg 261:459–467 · DOI
- Maglione MA, Gibbons MM, Livhits M, et al (2013) Bariatric surgery and non-surgical therapy in adults with metabolic conditions and a body mass index of 30.0 to 34.9 kg/m2. AHRQ Comparative Effectiveness Reviews, No. 82. Available from www.ncbi.nlm.nih.gov/books/NBK148685/ . Accessed 9 October 2017
- Consensus Development Conference Panel (1991) Gastrointestinal surgery for severe obesity. Ann Intern Med 115:956–961 · DOI · Paper page
- Aminian A, Brethauer SA, Kirwan JP, Kashyap SR, Burguera B, Schauer PR (2015) How safe is metabolic/diabetes surgery? Diabetes Obes Metab 17:198–201 · DOI
- Keating C, Neovius M, Sjoholm K et al (2015) Health-care costs over 15 years after bariatric surgery for patients with different baseline glucose status: results from the Swedish Obese Subjects study. Lancet Diabetes Endocrinol 3:855–865 · DOI
- CDC Diabetes Cost-Effectiveness Group (2002) Cost-effectiveness of intensive glycaemic control, intensified hypertension control, and serum cholesterol level reduction for type 2 diabetes. JAMA 287:2542–2551 · DOI
- Rubino F, Schauer PR, Kaplan LM, Cummings DE (2010) Metabolic surgery to treat type 2 diabetes: clinical outcomes and mechanisms of action. Annu Rev Med 61:393–411 · DOI
- Lee WJ, Wang W, Lee YC, Huang MT, Ser KH, Chen JC (2008) Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI >35 and <35 kg/m2. J Gastrointest Surg 12:945–952 · DOI
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Joint international consensus statement for ending stigma of obesity
Rubino, F., Puhl, R. M., Cummings, D. E., Eckel, R. H., Ryan, D. H., Mechanick, J. I., Nadglowski, J., Ramos Salas, X., Schauer, P. R., Twenefour, D., et al. (2020) · Nature Medicine · doi:10.1038/s41591-020-0803-x · Cited by 1,152
“However, evidence demonstrates that surgical interventions elicit numerous metabolic effects opposite to the compensatory physiologic responses normally triggered by dietinduced weight reduction, thereby promoting major, long-term weight loss 99 .”
BackgroundMingrone, G., Panunzi, S., De Gaetano, A., Guidone, C., Iaconelli, A., Capristo, E., Chamseddine, G., Bornstein, S. R., & Rubino, F. (2021) · The Lancet · doi:10.1016/s0140-6736(20)32649-0 · Cited by 577
Self-citationKnowledge gaps and weight stigma shape attitudes toward obesity
O'Keeffe, M., Flint, S. W., Watts, K., & Rubino, F. (2020) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(20)30073-5 · Cited by 80
Self-citation
Metadata
- Authors
- Cummings, D. E., & Rubino, F.
- Affiliations
- University of Washington (US)
- King's College London (GB)
- Corresponding author
- Cummings, David E.
- Rubino, Francesco
- ORCID
- Rubino, Francesco
- Venue
- Diabetologia
- Published
- 2017-12-09
- Volume
- 61
- Issue
- 2
- Pages
- 257-264
- ISSN
- 0012-186X (ISSN-L)
- 1432-0428
- PMC
- PMC6448954
- OpenAlex
- W2773563276
- Cited by
- 179
- References
- 10
- Citations by year
- 2026: 11 · 2025: 12 · 2024: 18 · 2023: 33 · 2022: 28 · 2021: 20 · 2020: 24 · 2019: 21 · 2018: 11 · 2017: 1
- FWCI
- 15.90
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Diabetologia (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- King's College London
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Surgery › Minimally Invasive Surgical Techniques
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- metabolic surgery, bariatric surgery, type 2 diabetes, obesity, diabetes remission, cardiovascular risk factors, microvascular complications, cost-effectiveness, surgical indications, body mass index thresholds
- MeSH terms
- Diabetes Mellitus, Type 2, Female, Humans, Male, Obesity, Gastric Bypass, Treatment Outcome, Bariatric Surgery
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