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The sum of many parts: potential mechanisms for improvement in glucose homeostasis after bariatric surgery
The sum of many parts: potential mechanisms for improvement in glucose homeostasis after bariatric surgery
- Source :
- Current diabetes reports. 14(5)
- Publication Year :
- 2014
-
Abstract
- Bariatric surgery has emerged as the most durably effective treatment of type 2 diabetes (DM). However, the mechanisms governing improvement in glucose homeostasis have yet to be fully elucidated. In this review we discuss the various types of surgical interventions and the multitude of factors that potentially mediate the effects on glycemia, such as altered delivery of nutrients to the distal ileum, duodenal exclusion, gut hormone changes, bile acid reabsorption, and amino acid metabolism. Accumulating evidence that some of these changes seem to be independent of weight loss questions the rationale of using body mass index as the major indication for surgery in diabetic patients. Understanding the complex mechanisms and interactions underlying improved glycemic control could lead to novel therapeutic targets and would also allow for greater individualization of therapy and optimization of surgical outcomes.
- Subjects :
- Male
medicine.medical_specialty
Endocrinology, Diabetes and Metabolism
Bariatric Surgery
Type 2 diabetes
Incretins
Article
Body Mass Index
Insulin resistance
Weight loss
Glucagon-Like Peptide 1
Diabetes mellitus
Weight Loss
Internal Medicine
medicine
Glucose homeostasis
Homeostasis
Humans
Peptide YY
Glycemic
Caloric Restriction
Randomized Controlled Trials as Topic
Glycated Hemoglobin
Adiponectin
business.industry
Remission Induction
medicine.disease
Surgery
Obesity, Morbid
Glucose
Treatment Outcome
Diabetes Mellitus, Type 2
Female
medicine.symptom
Insulin Resistance
business
Subjects
Details
- ISSN :
- 15390829
- Volume :
- 14
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Current diabetes reports
- Accession number :
- edsair.doi.dedup.....b6d1f836f6fcadefba4a77449ffc9079