title: Metabolic surgery for type 2 diabetes:  efficacy and risks.
abstract: OBJECTIVE
  Bariatric surgery has emerged as a highly effective treatment for obesity and is increasingly recognized to have benefits for glycemic management in patients with pre-existing type 2 diabetes mellitus (T2DM), and for diabetes prevention. This article will review the efficacy and mechanisms of metabolic surgery for the treatment of T2DM.
  
  
  RESULTS
  Recent small randomized studies with 1-2 years of follow-up begin to provide level 1 data of the effects of surgical procedures compared to medical management on glycemic control. Physiology studies using sophisticated metabolic techniques to evaluate insulin secretion, action, and entero-endocrine changes in patients preoperatively and postoperatively have shed light on the mechanisms that lead to changes in glycemia observed after bariatric surgery.
  
  
  CONCLUSIONS
  Understanding the efficacy and physiologic effects of bariatric surgery on metabolism will help guide patient management in the context of a growing epidemic of obesity and T2DM, and may also ultimately enable us to develop less invasive but equally effective therapeutic strategies for weight loss and metabolic control.
authors: Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
authors: Florencia
authors: F
authors: Halperin
authors: Allison B
authors: AB
authors: Goldfine
mesh_terms: D050110:Bariatric Surgery / Q000009:adverse effects / Q000379:methods; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000601:surgery*; D005500:Follow-Up Studies; D006946:Hyperinsulinism / Q000097:blood / Q000209:etiology*; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology*; D007408:Intestinal Absorption; D009767:Obesity, Morbid / Q000097:blood / Q000150:complications / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D018579:Patient Selection; D011183:Postoperative Complications / Q000097:blood / Q000503:physiopathology; D011655:Pulmonary Embolism / Q000097:blood / Q000209:etiology*; D016032:Randomized Controlled Trials as Topic; D012074:Remission Induction; D018805:Sepsis / Q000097:blood / Q000209:etiology*; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D001786:Blood Glucose