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conferenceseries
.com
Volume 8
Journal of Gastrointestinal & Digestive System
ISSN: 2161-069X
Bariatric Surgery 2018 & Gastro 2018
March 15-16, 2018
JOINT EVENT
12
th
Global Gastroenterologists Meeting
3
rd
International Conference on Metabolic and Bariatric Surgery
&
March 15-16, 2018 Barcelona, Spain
Diabetes remission with surgery beyond weight loss
Karl Miller
FACS, FASBMS, Austria
O
besity and its associated diseases such as type 2 diabetes have a serious effect on the health of people in the Middle East.
One in 10 adults have diabetes; half of them undiagnosed, and cases of type 2 diabetes (T2D) are rapidly increasing in the
region. Intense discussions in the use of metabolic surgery has been growing over the last years, powered by experimental and
clinical studies showing that rearrangements of gastro intestinal anatomy, formerly named bariatric operations can directly
affect glucose homeostasis, and not only through weight loss. Bariatric surgery versus intensive medical therapy for diabetes
has shown significant favour for surgery in several randomized controlled studies even in a five year follow up study recently
published. Endpoint results suggest that bariatric surgery, particularly gastric bypass, in combination with intensive medical
therapy is more effective than intensive medical therapy alone in controlling various characteristics associated with T2D. Even
before significant weight loss, metabolic surgery shows direct positive influence on interleukin (IL)-6, leptin and adiponectin,
IL-8, levels and on the transformation of growth factor beta (TGF-β), and the incretin hormone glucagon-like peptide-1
(GLP-1) as well as in lowering insulin resistance. The presentation will explore the evidence that shows how metabolic surgery
influences complex metabolic mechanisms that span from functional elements, such as the role of the stomach and of gastric
emptying, the absorption and digestion, to hormonal elements such as incretins, gut endocrine regulation, in addition to
hepatobiliary, neural regulation, and gut microbiota elements, in the diabetes metabolism of obese subjects. Thus, the American
Diabetes Association implemented metabolic surgery in the treatment algorithm for T2D based on the mounting scientific
evidence.
karl@miller.co.atJ Gastrointest Dig Syst 2018, Volume 8
DOI: 10.4172/2161-069X-C1-065