title: Bariatric surgery as a treatment option in patients with type 2 diabetes mellitus.
abstract: Type 2 diabetes mellitus (T2DM) is a leading cause of blindness, non-traumatic amputation and end-stage renal disease as well as a major cardiovascular risk factor. Tight glycemic control reduces the incidence of microvascular complications of T2DM whereas its effects on macrovascular complication are more controversial. However, glycemic targets are achieved by a minority of diabetic patients despite the availability of several antidiabetic agents. In the present commentary, we discuss the findings of two recent randomized studies that compared bariatric surgery with medical treatment in patients with uncontrolled T2DM. Both studies showed that bariatric surgery results in remission of T2DM in the majority of patients. However, both studies were limited to relatively young patients without comorbidities, had relatively short follow-up and did not assess the effects of surgery on T2DM complications. Moreover, the perioperative complications of bariatric surgery and its limited availability in some areas are additional barriers to the wider implementation of this therapeutic approach. On the other hand, the elucidation of the mechanisms underpinning the resolution of T2DM following bariatric surgery might result in the development of novel, more effective pharmacotherapies for this common disease.
authors.affiliation: Marianna Spanou, Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, AHEPA Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece.
authors.forename: Marianna
authors.initials: M
authors.lastname: Spanou
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tziomalos
keywords: Adjustable gastric banding; Bariatric surgery; Biliopancreatic diversion; Roux-en-Y gastric bypass; Sleeve gastrectomy; Type 2 diabetes mellitu