Bariatric surgery leads to substantial and durable weight reduction.
Nearly 30% of patients who undergo bariatric surgery have type 2 diabetes, and for many of them, diabetes resolves after surgery.
Glycemic control improves in part because of caloric restriction but also because gut peptide secretion changes.
|Nearly 30% who undergo bariatric surgery have type 2 diabetes|
|Annals of Internal Medicine|
Gut peptides, which mediate the enteroinsular axis, include the incretins glucagon-like peptide-1 and glucose-dependent insulinotropic peptide, as well as ghrelin and peptide YY.
Dr Marion Vetter and colleagues reviewed the various bariatric procedures and how they alter the enteroinsular axis.
Bariatric surgery, particularly bypass procedures, alters secretion of these gut hormones, which results in enhanced insulin secretion and sensitivity.
Dr Vetter's team concluded, “Familiarity with these effects can help physicians decide among the different surgical procedures and avoid postoperative hypoglycemia.”