Section of GI Metabolic Surgery, New York Presbyterian Hospital and Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, USA.
Endocrine. 2011 Oct;40(2):151-61. doi: 10.1007/s12020-011-9508-8. Epub 2011 Aug 13.
Type 2 diabetes mellitus (T2DM) is a major health priority globally, having achieved pandemic status in the twenty-first century. Several gastrointestinal procedures that were primarily designed to treat morbid obesity result in dramatic remission of diabetes. Studies in experimental rodent models and humans have shown that the glycemic benefits of surgery are at least in part weight-independent and extend to non-morbidly obese subjects with T2DM. Bariatric procedures differ in their ability to ameliorate type 2 diabetes, with intestinal bypass procedures being more effective than purely restrictive procedures. Several studies have demonstrated that the benefits of bariatric surgery extend beyond amelioration of hyperglycemia and include improvement in other cardiovascular risk factors such as dyslipidemia and hypertension. The safety and cost-effectiveness of bariatric surgery are also well established by several studies. In this paper, the authors present the surgeon perspective on the management of type 2 diabetes focusing on the efficacy, safety and cost-effectiveness of metabolic surgery. The available evidence warrants the inclusion of metabolic surgery in the treatment algorithm of type 2 diabetes.
2 型糖尿病（T2DM）是全球主要的健康重点，在 21 世纪已达到大流行状态。几种主要用于治疗病态肥胖的胃肠道手术可显著缓解糖尿病。实验性啮齿动物模型和人类的研究表明，手术的血糖益处至少部分是独立于体重的，并扩展到非病态肥胖的 T2DM 患者。减重手术在改善 2 型糖尿病方面的效果不同，肠旁路手术比单纯的限制性手术更有效。几项研究表明，减重手术的益处不仅限于改善高血糖，还包括改善其他心血管风险因素，如血脂异常和高血压。几项研究也证实了减重手术的安全性和成本效益。在本文中，作者从外科医生的角度介绍了 2 型糖尿病的管理，重点关注代谢手术的疗效、安全性和成本效益。现有证据证明代谢手术应该纳入 2 型糖尿病的治疗方案中。
