Jin ZL, Liu W. Progress in treatment of type 2 diabetes by bariatric surgery. World J Diabetes 2021; 12(8): 1187-1199 [PMID: 34512886 DOI: 10.4239/wjd.v12.i8.1187]
Corresponding Author of This Article
Wei Liu, FACS, MD, Professor, Department of General Surgery & Department of Biliopancreatic and Metabolic Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Road, Changsha 410011, Hunan Province, China. liuweixy@csu.edu.cn
Research Domain of This Article
Surgery
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Aug 15, 2021; 12(8): 1187-1199 Published online Aug 15, 2021. doi: 10.4239/wjd.v12.i8.1187
Progress in treatment of type 2 diabetes by bariatric surgery
Zhang-Liu Jin, Wei Liu
Zhang-Liu Jin, Wei Liu, Department of General Surgery & Department of Biliopancreatic and Metabolic Surgery, The Second Xiangya Hospital, Central South University, Changsha 410011, Hunan Province, China
Author contributions: Jin ZL and Liu W contributed to the conception and design of the study, preparation of the content, and writing of the paper.
Supported byNational Natural Science Foundation of China, No. 81670481.
Conflict-of-interest statement: The authors declare having no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wei Liu, FACS, MD, Professor, Department of General Surgery & Department of Biliopancreatic and Metabolic Surgery, The Second Xiangya Hospital, Central South University, No. 139 Renmin Road, Changsha 410011, Hunan Province, China. liuweixy@csu.edu.cn
Received: February 17, 2021 Peer-review started: February 17, 2021 First decision: March 16, 2021 Revised: March 29, 2021 Accepted: July 6, 2021 Article in press: July 6, 2021 Published online: August 15, 2021
Abstract
The incidence of type 2 diabetes (T2D) is increasing at an alarming rate worldwide. Bariatric surgical procedures, such as the vertical sleeve gastrectomy and Roux-en-Y gastric bypass, are the most efficient approaches to obtain substantial and durable remission of T2D. The benefits of bariatric surgery are realized through the consequent increased satiety and alterations in gastrointestinal hormones, bile acids, and the intestinal microbiota. A comprehensive understanding of the mechanisms by which various bariatric surgical procedures exert their benefits on T2D could contribute to the design of better non-surgical treatments for T2D. In this review, we describe the classification and evolution of bariatric surgery and explore the multiple mechanisms underlying the effect of bariatric surgery on insulin resistance. Based upon our summarization of the current knowledge on the underlying mechanisms, we speculate that the gut might act as a new target for improving T2D. Our ultimate goal with this review is to provide a better understanding of T2D pathophysiology in order to support development of T2D treatments that are less invasive and more scalable.
Core Tip: Bariatric surgery is an effective treatment for type 2 diabetes (T2D), providing long-term remission. Among these types of weight loss procedures, the vertical sleeve gastrectomy and Roux-en-Y gastric bypass are extensively performed worldwide, but in the United States especially. Through establishment of reduced caloric intake and alterations in gut hormones, bile acids, and intestinal microbes, these procedures also contribute to the resolution of T2D. Understanding the mechanisms underlying the effects of bariatric surgery on T2D might provide new targets for more effective non-surgical treatments, such as medications, for T2D.
