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The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?

It is now established that metabolic surgery (also known as bariatric surgery or obesity surgery) is an effective treatment for type 2 diabetes. Data from several randomized controlled trials have shown that surgery, when used as an adjunct to best medical therapy, is superior to medical therapy alo...

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Autores principales: Neff, Karl J., Le Roux, Carel W.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272689/
https://www.ncbi.nlm.nih.gov/pubmed/32547487
http://dx.doi.org/10.3389/fendo.2020.00304
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author Neff, Karl J.
Le Roux, Carel W.
author_facet Neff, Karl J.
Le Roux, Carel W.
author_sort Neff, Karl J.
collection PubMed
description It is now established that metabolic surgery (also known as bariatric surgery or obesity surgery) is an effective treatment for type 2 diabetes. Data from several randomized controlled trials have shown that surgery, when used as an adjunct to best medical therapy, is superior to medical therapy alone in achieving glycaemic and metabolic treatment targets in diabetes care. This has resulting in metabolic surgery being recommended as a treatment option for obesity-associated type 2 diabetes in national and international diabetes care guidelines. While the superior glycaemic effect of surgery is clear, the effect of surgery on the complications of diabetes is not fully understood. There are observational and epidemiological data that indicate a preventative effect in cohorts who do not have complications at baseline, as well as a positive effect on those with established diabetic kidney disease. However, there is a dearth of randomized controlled studies that specifically examine the effect of surgery on the complications of diabetes. Therefore, we should remain cautious in some cases, especially in those with retinopathy or neuropathy, as there is potential for deterioration of disease post-operatively. Further study is needed on this important topic. A lot is known, but there remain several unanswered questions. This article summarizes what we know about the effect of metabolic surgery on the complications of diabetes, poses some unanswered questions, and suggests how we could answer them.
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spelling pubmed-72726892020-06-15 The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions? Neff, Karl J. Le Roux, Carel W. Front Endocrinol (Lausanne) Endocrinology It is now established that metabolic surgery (also known as bariatric surgery or obesity surgery) is an effective treatment for type 2 diabetes. Data from several randomized controlled trials have shown that surgery, when used as an adjunct to best medical therapy, is superior to medical therapy alone in achieving glycaemic and metabolic treatment targets in diabetes care. This has resulting in metabolic surgery being recommended as a treatment option for obesity-associated type 2 diabetes in national and international diabetes care guidelines. While the superior glycaemic effect of surgery is clear, the effect of surgery on the complications of diabetes is not fully understood. There are observational and epidemiological data that indicate a preventative effect in cohorts who do not have complications at baseline, as well as a positive effect on those with established diabetic kidney disease. However, there is a dearth of randomized controlled studies that specifically examine the effect of surgery on the complications of diabetes. Therefore, we should remain cautious in some cases, especially in those with retinopathy or neuropathy, as there is potential for deterioration of disease post-operatively. Further study is needed on this important topic. A lot is known, but there remain several unanswered questions. This article summarizes what we know about the effect of metabolic surgery on the complications of diabetes, poses some unanswered questions, and suggests how we could answer them. Frontiers Media S.A. 2020-05-29 /pmc/articles/PMC7272689/ /pubmed/32547487 http://dx.doi.org/10.3389/fendo.2020.00304 Text en Copyright © 2020 Neff and Le Roux. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Neff, Karl J.
Le Roux, Carel W.
The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?
title The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?
title_full The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?
title_fullStr The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?
title_full_unstemmed The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?
title_short The Effect of Metabolic Surgery on the Complications of Diabetes: What Are the Unanswered Questions?
title_sort effect of metabolic surgery on the complications of diabetes: what are the unanswered questions?
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7272689/
https://www.ncbi.nlm.nih.gov/pubmed/32547487
http://dx.doi.org/10.3389/fendo.2020.00304
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