Possibilities of metabolic surgery for the treatment of type 2 diabetes mellitus in patients with grade 1 alimentary obesity
Vladimir V. Salukhov,
Nikita S. Ilinskii,
Evgenii V. Vasil'ev,
Ruslan T. Sardinov,
Dmitrii V. Gladyshev https://doi.org/10.14341/DM9292
Abstract
Many studies have demonstrated the high effectiveness of bariatric surgery in patients with grade 2–3 obesity and type 2 diabetes mellitus. Currently, surgery is one of the most effective ways to decrease body mass, to maintain long-term weight loss and to manage type 2 diabetes mellitus. Particular interest has been generated by the strong influence of bariatric surgical interventions on the disruption of carbohydrate metabolism in patients who undergo surgery. This change leads to an improvement in the course of type 2 diabetes mellitus as well as its full remission. This review presents information on the mechanisms that are needed to improve glycaemic control in patients with obesity even after bariatric surgery. This review also contains a comparative analysis of how various surgical interventions influence the course of diabetes, the reasons for postbariatric glycaemia and predictors of the effectiveness of bariatric surgeries in terms of metabolic control in patients with type 2 diabetes mellitus.
Until recently, the primary focus of the studies by bariatric surgeons was on patients with grade 2–3 obesity and type 2 diabetes mellitus. However, in this review, special attention is given to the patients with a body mass index that ranges from 30 to 35 kg/m. Gained experience of the bariatric surgeons leads to high effectiveness with respect to the influence on the course of diabetes in patients with grade 1 obesity, which allows us to significantly expand the range of patients who should be recommended for this surgery. In addition, some information concerning surgical and metabolic complications of bariatric surgical intervention is provided, which allows us to seriously consider this treatment.
About the Authors
Vladimir V. SalukhovS.M. Kirov Military Medical Academy
Russian Federation
Head of the 1st (Clinic of therapy for postgraduate course)
Nikita S. Ilinskii
S.M. Kirov Military Medical Academy
Russian Federation
resedent in therapy
Evgenii V. Vasil'ev
City Hospital №. 40
Russian Federation
endocrinologist
Ruslan T. Sardinov
S.M. Kirov Military Medical Academy
Russian Federation
Associate professor
Dmitrii V. Gladyshev
City Hospital №. 40
Russian Federation
Head in surgery
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6. Fig. 1. Chronology of the development of the main processes after DU, determining the probability of remission of CD2 [24]. | |
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7. Fig. 2. Basic mechanisms of DU, leading to remission of CD2 / improved glycemic control in patients (adapted [32]) | |
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8. Fig. 3. Algorithm for choosing treatment in a patient with diabetes, depending on BMI and glycemic control [41] (in Asian-born people, the BMI decreases by 2.5 kg / m2) | |
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Salukhov V.V., Ilinskii N.S., Vasil'ev E.V., Sardinov R.T., Gladyshev D.V. Possibilities of metabolic surgery for the treatment of type 2 diabetes mellitus in patients with grade 1 alimentary obesity. Diabetes mellitus. 2018;21(1):15-25. (In Russ.) https://doi.org/10.14341/DM9292
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