Journal of Gastrointestinal & Digestive System
Open Access

Abstract

Every bariatric surgical procedure currently being practised globally, also has metabolic advantages to varying extents according to the procedure, and generally depends on the extent of malabsorption induced by the procedure. Thus, BPD-DS procedure has shown the best remission and resolution rate among all the bariatric procedures. But the nutritional and other complications have prevented it from becoming a gold-standard procedure. The June 2016 issue of diabetes care has listed a set of 32 recommendations related to the use of metabolic surgery for treatment of type 2 diabetes. These are supported by high quality evidence, including RCTs and systematic reviews/meta-analyses that show dramatic and durable improvement in T2DM. The biologic rationale is based on the recognition of an important role of the gut in metabolic regulation and directly on glucose homeostasis. Thus, bariatric procedures are effective in diabesity and have changed the landscape of diabetes care. Strong evidence now demonstrates that procedures designed to be essentially metabolic like the ileal transposition which have minimal bariatric effects and do not cause any significant malabsorption, are showing great promise in the long-term resolution and remission of type 2 diabetes in patients with a BMI <35 kg/ m2. There is now level 1A evidence that surgery is superior for T2DM remission, glycemic control and HbA1C lowering, for selected patients with a BMI <35 kg/m2.

Biography

Email: bharucha.manoj@gmail.com