title: What is the evidence for metabolic surgery for type 2 diabetes? A critical perspective.
abstract: Bariatric surgery has emerged as a highly effective treatment not only for obesity, but also for type 2 diabetes (T2D). A meta-analysis has reported the complete resolution of T2D in 78.1% of cases of morbidly obese patients after bariatric surgery. Such extraordinary results obtained in diabetic patients with body mass index (BMI) scores>35kg/m2have led investigators to question whether similar results might be achieved in patients with BMIs<35kg/m2. Preliminary studies suggest that metabolic surgery is safe and effective in patients with T2D and a BMI<35kg/m2, whereas other studies report that metabolic surgery is less effective for promoting T2D remission in these patients. Thus, the results are discordant. Long-term studies would be useful for determining the safety, efficacy and cost-effectiveness of metabolic surgery for this population with T2D. In 2015, it is probably premature to say that metabolic surgery is an accepted treatment option for T2D patients with BMIs<35kg/m2.
authors.affiliation: AP-HP, Pierre and Marie Curie University (UPMC), Sorbonne University, Pitié-Salpêtrière-Charles Foix Hospital, Inserm UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Diabetology-Metabolism Department, 75013 Paris 6, France.
authors.forename: C
authors.initials: C
authors.lastname: Amouyal
authors.affiliation: AP-HP, Pierre and Marie Curie University (UPMC), Sorbonne University, Pitié-Salpêtrière-Charles Foix Hospital, Inserm UMRS 1166, Institute of Cardiometabolism and Nutrition (ICAN), Diabetology-Metabolism Department, 75013 Paris 6, France. Electronic address: fabrizio.andreelli@psl.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Andreelli
mesh_terms: D050110:Bariatric Surgery; D003924:Diabetes Mellitus, Type 2 / Q000601:surgery*; D006801:Humans; D009767:Obesity, Morbid / Q000601:surgery*
keywords: Bariatric surgery; Metabolic surgery; Obesity; Type 2 diabetes