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Gastrointestinal surgery as treatment for type 2 diabetes

Moo, Tracy-Ann; Rubino, Francesco

Current Opinion in Endocrinology, Diabetes and Obesity: April 2008 - Volume 15 - Issue 2 - p 153–158
doi: 10.1097/MED.0b013e3282f88a0a
Diabetes and the endocrine pancreas: Edited by Allison B. Goldfine
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Purpose of review As the incidence of type 2 diabetes continues to rise worldwide at epidemic proportions, endeavors to find more effective therapies increase. Gastrointestinal bypass surgery is now gaining awareness as a potential effective and long-term treatment.

Recent findings There is now a substantial body of evidence supporting the efficacy of gastrointestinal surgery in controlling type 2 diabetes. This is well documented in several studies of obese diabetic patients undergoing gastrointestinal bypass procedures. Additionally, smaller studies and case reports also demonstrate the efficacy of gastrointestinal bypass surgery in nonobese diabetic patients. The pathophysiologic basis of the improvement in diabetes after gastrointestinal bypass surgery is still unclear; however, the dominant hypotheses involve changes in hormone signaling from the small bowel.

Summary The implications of ‘diabetes surgery’ are vast, and could dramatically change the face of diabetes as we know it today. In clinical practice surgery could represent an alternative for the treatment of diabetes. On a broader perspective, surgery may facilitate research aimed at understanding the etiology of the disease.

Weill Cornell Medical College of Cornell University-New York Presbyterian Hospital, New York, New York, USA

Correspondence to Francesco Rubino, MD, Gastrointestinal Metabolic Surgery, Department of Surgery, Weill Cornell Medical College of Cornell University-New York Presbyterian Hospital, 525 East 68th Street, Box 294, New York, NY 10065, USA E-mail: frr2007@med.cornell.edu

© 2008 Lippincott Williams & Wilkins, Inc.