Potential of Surgery for Curing Type 2 Diabetes Mellitus

Francesco Rubino, MD, Michel Gagner, MD, FACS, FRCSC

Disclosures

Annals of Surgery. 2002;236(5) 

In This Article

Summary and Conclusions

GBP and BPD seem to be an effective form of therapy for type 2 diabetes, at least in morbidly obese patients. Significant changes in gastrointestinal hormones have been documented, but no clear explanation has been given yet about the mechanism of action of this surgery. The bypass of the duodenum and proximal jejunum, a common feature of both GBP and BPD, may contrasts a hormonal or neural signaling originating from the gut in response to the passage of food and responsible for the impaired action and/or secretion of insulin that characterizes type 2 diabetes. Case reports and observations on the timing of the restoration of glucose metabolism after surgery suggest that the control of diabetes occurs as a primary, specific, and independent effect of this surgery, not secondary to the treatment of overweight.

Controlled trials in centers with a wide experience of GBP surgery are needed to verify the possibility of a surgical cure specific for type 2 diabetes; however, surgeries for obesity seem to have a potential for changing the current concepts of the pathophysiology of type 2 diabetes and, possibly, the management of this disease.

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