title: Obesity, Type 2 Diabetes, and the Metabolic Syndrome: Pathophysiologic Relationships and Guidelines for Surgical Intervention.
abstract: Several gastrointestinal (GI) operations originally developed for the treatment of severe obesity (bariatric surgery) promote sustained weight loss as well as dramatic, durable improvements of insulin-resistant states, most notably type 2 diabetes mellitus (T2DM). Experimental evidence shows that some rearrangements of GI anatomy can directly affect glucose homeostasis, insulin sensitivity, and inflammation, supporting the idea that the GI tract is a biologically rational target for interventions aimed at correcting pathophysiologic aspects of cardiometabolic disorders. This article reviews the pathophysiology of metabolic disease and the role of bariatric/metabolic surgery in current clinical guidelines for the treatment of obesity and T2DM.
authors.affiliation: Bariatric and Metabolic Surgery, Division of Diabetes and Nutritional Sciences, King's College London and King's College Hospital, London SE5 9RS, UK.
authors.forename: Laurent
authors.initials: L
authors.lastname: Genser
authors.affiliation: Bariatric and Metabolic Surgery, Division of Diabetes and Nutritional Sciences, King's College London and King's College Hospital, London SE5 9RS, UK.
authors.forename: James Rossario
authors.initials: JR
authors.lastname: Casella Mariolo
authors.affiliation: Bariatric and Metabolic Surgery, Division of Diabetes and Nutritional Sciences, King's College London and King's College Hospital, London SE5 9RS, UK.
authors.forename: Lidia
authors.initials: L
authors.lastname: Castagneto-Gissey
authors.affiliation: Bariatric and Metabolic Surgery, Division of Diabetes and Nutritional Sciences, King's College London and King's College Hospital, London SE5 9RS, UK.
authors.forename: Spyros
authors.initials: S
authors.lastname: Panagiotopoulos
authors.affiliation: Bariatric and Metabolic Surgery, Division of Diabetes and Nutritional Sciences, King's College London and King's College Hospital, London SE5 9RS, UK. Electronic address: Francesco.rubino@kcl.ac.uk.
authors.forename: Francesco
authors.initials: F
authors.lastname: Rubino
mesh_terms: D050110:Bariatric Surgery; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D024821:Metabolic Syndrome / Q000503:physiopathology / Q000601:surgery*; D009765:Obesity / Q000503:physiopathology / Q000601:surgery*; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
keywords: Bariatric metabolic surgery; Diabetes; Gut; Insulin resistance; Metabolic syndrome; Microbiota; Obesity