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Bariatric surgery: a cure for diabetes?

Varela, J Esteban

Current Opinion in Clinical Nutrition & Metabolic Care: July 2011 - Volume 14 - Issue 4 - p 396–401
doi: 10.1097/MCO.0b013e3283468e50
Carbohydrates: Edited by Luc Tappy and Bettina Mittendorfer

Purpose of review To review the basic mechanisms of caloric intake reduction of bariatric surgery and its clinical and metabolic outcomes. To describe novel bariatric procedures, their effects on glucose homeostasis and insulin sensitivity and to explain the proposed mechanisms for type 2 diabetes mellitus (T2DM) resolution.

Recent findings The effects of surgically induced weight loss on T2DM have elucidated in part the role of proximal and distal gastrointestinal bypass on insulin sensitivity. A dual mechanism for improvement in glucose homeostasis after bariatric surgery has been proposed that appears to be weight loss independent.

Summary Bariatric surgery is the most effective therapy for obesity and obesity-related comorbidities today that provide high rates of resolution of T2DM with improvements in insulin resistance and β-cell function. Novel bariatric procedures offer a unique opportunity to understand the pathophysiology of T2DM and to identify potential pharmacologic targets for effective T2DM treatments and a potential cure.

Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA

Correspondence to J.E. Varela, MD, MPH, FACS, FASMBS, Associate Professor of Surgery, Section of Minimally Invasive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Box 8109, St. Louis, MO 63110, USA E-mail:

© 2011 Lippincott Williams & Wilkins, Inc.