The impact of bariatric surgery on remission and complications of type 2 Diabetes Mellitus
DOI:
https://doi.org/10.33448/rsd-v13i3.45197Keywords:
Diabetes Mellitus; Bariatric surgery; Diabetes complications; Obesity.Abstract
Introduction: Bariatric surgery (BS) has proven to be a great ally not only in the treatment of obesity but also of Diabetes Mellitus (DM), due to its various impacts on glucose homeostasis. The most studied surgeries in terms of efficacy and safety are Roux-en-Y Gastric Bypass (RYGB), Sleeve Gastrectomy (SG), Biliopancreatic Diversion (BPD), and Laparoscopic Adjustable Gastric Banding (LAGB). The aim of this study is to evaluate the impacts of different BS techniques on the remission of type 2 diabetes (DM2) and on micro and macrovascular complications. Methodology: This is an integrative review about the impact of BS on DM2. Data from the Virtual Health Library (VHL), Scientific Electronic Library Online (SciELO), and the National Library of Medicine (PubMed) were used, crossing the descriptors "Bariatric Surgery", "Diabetes Mellitus", "Complications", and "Remission", to answer the question formulated through the PICO strategy. Results and Discussion: RYGB and SG stand out in DM2 remission rates, with similar statistics, especially in the long term. The impact on macrovascular complications is positive, especially in the incidence of cardiovascular events. Regarding microvascular complications, the positive impact of BS on diabetic nephropathy stands out, while evidence regarding diabetic retinopathy is still inconclusive. Conclusion: Factors that improve BS outcomes should be taken into account, such as patient age, duration of the disease, and HbA1c levels. Even after remission, continuous nutritional, physical, and glycemic monitoring should be maintained.
References
Affinati, A. H., Esfandiari, N. H., Oral, E. A., & Kraftson, A. T. (2019). Bariatric Surgery in the Treatment of Type 2 Diabetes. Current diabetes reports, 19(12), 156. https://doi.org/10.1007/s11892-019-1269-4
Balasubaramaniam, V., & Pouwels, S. (2023). Remission of Type 2 Diabetes Mellitus (T2DM) after Sleeve Gastrectomy (SG), One-Anastomosis Gastric Bypass (OAGB), and Roux-en-Y Gastric Bypass (RYGB): A Systematic Review. Medicina (Kaunas, Lithuania), 59(5), 985. https://doi.org/10.3390/medicina59050985
Bottino, R., Carbone, A., Formisano, T., D’Elia, S., Orlandi, M., Sperlongano, S., Molinari, D., Castaldo, P., Palladino, A., Barbareschi, C., Tolone, S., Docimo, L., & Cimmino, G. (2023). Cardiovascular Effects of Weight Loss in Obese Patients with Diabetes: Is Bariatric Surgery the Additional Arrow in the Quiver? Life, 13(7), 1552. https://doi.org/10.3390/life13071552
Borgeraas, H., Hofsø, D., Hertel, J. K., & Hjelmesaeth, J. (2020). Comparison of the effect of Roux-en-Y gastric bypass and sleeve gastrectomy on remission of type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Obesity reviews: an official journal of the International Association for the Study of Obesity, 21(6), e13011. https://doi.org/10.1111/obr.13011
Camargos A. R., Barros B. G. do N., Pena D. P., Amorim D. S., Freitas E. N., Zaraket F., Guiotti J., Ribeiro L. C. G., Chequer L. B. N., & Corrêa W. P. (2021). A eficácia das técnicas da cirurgia bariátrica na remissão da diabetes mellitus tipo 2. Revista Eletrônica Acervo Científico, 26, e7541. https://doi.org/10.25248/reac.e7541.2021
Cho, J. M., Kim, H. J., Lo Menzo, E., Park, S., Szomstein, S., & Rosenthal, R. J. (2015). Effect of sleeve gastrectomy on type 2 diabetes as an alternative treatment modality to Roux-en-Y gastric bypass: systemic review and meta-analysis. Surgery for obesity and related diseases: official journal of the American Society for Bariatric Surgery, 11(6), 1273–1280. https://doi.org/10.1016/j.soard.2015.03.001
Dascalu, A. M., Stoian, A. P., Cherecheanu, A. P., Serban, D., Costea, D. O., Tudosie, M. S., Stana, D., Tanasescu, D., Sabau, A. D., Gangura, G. A., Costea, A. C., Nicolae, V. A., & Smarandache, C. G. (2021). Outcomes of Diabetic Retinopathy Post-Bariatric Surgery in Patients with Type 2 Diabetes Mellitus. Journal of Clinical Medicine, 10(16), 3736. https://doi.org/10.3390/jcm10163736
Fisher, D. P., Johnson, E., Haneuse, S., Arterburn, D., Coleman, K. J., O'Connor, P. J., O'Brien, R., Bogart, A., Theis, M. K., Anau, J., Schroeder, E. B., & Sidney, S. (2018). Association Between Bariatric Surgery and Macrovascular Disease Outcomes in Patients With Type 2 Diabetes and Severe Obesity. JAMA, 320(15), 1570–1582. https://doi.org/10.1001/jama.2018.14619
Gorman, D. M., le Roux, C. W., & Docherty, N. G. (2016). The Effect of Bariatric Surgery on Diabetic Retinopathy: Good, Bad, or Both? Diabetes & Metabolism Journal, 40(5), 354. https://doi.org/10.4093/dmj.2016.40.5.354
Hallberg, S. J., Gershuni, V. M., Hazbun, T. L., & Athinarayanan, S. J. (2019). Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Nutrients, 11(4), 766. https://doi.org/10.3390/nu11040766
Jackson, S., le Roux, C. W., & Docherty, N. G. (2014). Bariatric surgery and microvascular complications of type 2 diabetes mellitus. Current atherosclerosis reports, 16(11), 453. https://doi.org/10.1007/s11883-014-0453-x
Ji, Y., Lee, H., Kaura, S., Yip, J., Sun, H., Guan, L., Han, W., & Ding, Y. (2021). Effect of Bariatric Surgery on Metabolic Diseases and Underlying Mechanisms. Biomolecules, 11(11), 1582. https://doi.org/10.3390/biom11111582
Koliaki, C., Liatis, S., le Roux, C. W., & Kokkinos, A. (2017). The role of bariatric surgery to treat diabetes: current challenges and perspectives. BMC Endocrine Disorders, 17(1). https://doi.org/10.1186/s12902-017-0202-6
Leitner, D. R., Frühbeck, G., Yumuk, V., Schindler, K., Micic, D., Woodward, E., & Toplak, H. (2017). Obesity and Type 2 Diabetes: Two Diseases with a Need for Combined Treatment Strategies - EASO Can Lead the Way. Obesity facts, 10(5), 483–492. https://doi.org/10.1159/000480525
Madsen, L. R., Baggesen, L. M., Richelsen, B., & Thomsen, R. W. (2019). Effect of Roux-en-Y gastric bypass surgery on diabetes remission and complications in individuals with type 2 diabetes: a Danish population-based matched cohort study. Diabetologia, 62(4), 611–620. https://doi.org/10.1007/s00125-019-4816-2
O'Brien, R., Johnson, E., Haneuse, S., Coleman, K. J., O'Connor, P. J., Fisher, D. P., Sidney, S., Bogart, A., Theis, M. K., Anau, J., Schroeder, E. B., & Arterburn, D. (2018). Microvascular Outcomes in Patients with Diabetes After Bariatric Surgery Versus Usual Care: A Matched Cohort Study. Annals of internal medicine, 169(5), 300–310. https://doi.org/10.7326/M17-2383
Roslin, M. S., & Cripps, C. N. (2016). Bariatric surgery in managing diabetes mellitus. Current opinion in gastroenterology, 32(6), 481–486. https://doi.org/10.1097/MOG.0000000000000312
Sandoval, D. A., & Patti, M. E. (2023). Glucose metabolism after bariatric surgery: implications for T2DM remission and hypoglycaemia. Nature reviews. Endocrinology, 19(3), 164–176. https://doi.org/10.1038/s41574-022-00757-5
Souza, M. T. de, Silva, M. D., & Carvalho, R. de. (2010). Integrative Review: What Is It? How to Do It? Einstein (São Paulo), 8(1), 102–106. https://doi.org/10.1590/s1679-45082010rw1134
Wang, C., He, B., Piao, D., & Han, P. (2016). Roux-en-Y Esophagojejunostomy Ameliorates Renal Function Through Reduction of Renal Inflammatory and Fibrotic Markers in Diabetic Nephropathy. Obesity surgery, 26(7), 1402–1413. https://doi.org/10.1007/s11695-015-1947-5
Yan, G., Wang, J., Zhang, J., Gao, K., Zhao, Q., & Xu, X. (2019). Long-term outcomes of macrovascular diseases and metabolic indicators of bariatric surgery for severe obesity type 2 diabetes patients with a meta-analysis. PloS one, 14(12), e0224828. https://doi.org/10.1371/journal.pone.0224828
Yska, J. P., van Roon, E. N., de Boer, A., Leufkens, H. G., Wilffert, B., de Heide, L. J., de Vries, F., & Lalmohamed, A. (2015). Remission of Type 2 Diabetes Mellitus in Patients After Different Types of Bariatric Surgery: A Population-Based Cohort Study in the United Kingdom. JAMA surgery, 150(12), 1126–1133. https://doi.org/10.1001/jamasurg.2015.2398
Yu, C. W., Park, L. J., Pinto, A., Ma, O. N., Lee, Y., Gupta, R., Chaudhary, V., Doumouras, A. G., & Hong, D. (2021). The Impact of Bariatric Surgery on Diabetic Retinopathy: A Systematic Review and Meta-Analysis. American journal of ophthalmology, 225, 117–127. https://doi.org/10.1016/j.ajo.2020.12.033
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Copyright (c) 2024 Luiz Otávio da Silva; Gustavo Henrique Silva Souza; Gabryel Luz Heinzemann; Gabriel de Carvalho Claudino; Beatriz Lima Leite de Silveira; Leonardo Cheble Soares de Pinho; Camila Cornacchia; Patricia da Silveira Barbosa; Johanna Pocker Lemos Hourneaux de Moura; Bruno Pithon Costa Souza
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