title: Bariatric and metabolic surgery and microvascular complications of type 2 diabetes mellitus.
abstract: BACKGROUND
  Metabolic dysregulation is the defining characteristic of type 2 diabetes mellitus (T2DM) and may lead to microvascular complications, specifically retinopathy, nephropathy and neuropathy. Medical treatment and lifestyle interventions targeting risk factors for microvascular complications can yield therapeutic gains, particularly retinopathy and nephropathy. Bariatric/metabolic surgery is superior to the best medical treatment in several randomized controlled trials. Consequently, evidence of the effect of bariatric/metabolic surgery on microvascular complications is now emerging in the literature.
  
  
  METHODS
  A search of the recent published evidence base on the effects of bariatric/metabolic surgery on microvascular complications reveals further evidence that supports the efficacy of surgery in preventing the incidence and progression of albuminuria and preserving renal functional decline.
  
  
  CONCLUSIONS
  Data on retinopathy are ambivalent representing the potential in some cases for an influence of reactive hypoglycaemia over the retina but the majority of data emphasize that the metabolic control can halt the progression of the eye disease. A significant gap in the literature remains in relation to the effects of surgery on diabetic neuropathy, although some information sheds a light on the benefits secondary to the surgical metabolic control.
  
  
  CONCLUSIONS
  Overall, although data so far is exciting, there is a pressing need for prospective randomized controlled trials examining long-term microvascular outcomes following bariatric/metabolic surgery in patients with T2DM.
authors.affiliation: Hospital Alemão Oswaldo Cruz, BR.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Cohen
authors.affiliation: Hospital Alemão Oswaldo Cruz, BR.
authors.forename: Fernando
authors.initials: F
authors.lastname: Pechy
authors.affiliation: Hospital Alemão Oswaldo Cruz, BR.
authors.forename: Tarissa
authors.initials: T
authors.lastname: Petry
authors.affiliation: Hospital Alemão Oswaldo Cruz, BR.
authors.forename: José Luis
authors.initials: JL
authors.lastname: Correa
authors.affiliation: Hospital Alemão Oswaldo Cruz, BR.
authors.forename: Pedro Paulo
authors.initials: PP
authors.lastname: Caravatto
authors.affiliation: Hospital Alemão Oswaldo Cruz, BR.
authors.forename: Carmen
authors.initials: C
authors.lastname: Tzanno-Martins
mesh_terms: D050110:Bariatric Surgery; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000209:etiology* / Q000601:surgery*; D006801:Humans; D055806:Microvessels; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome