Meyvis Karen, De Block Christophe, Van Gaal Luc F
Endocrinologist.
Associate Professor of Medicine.
Eur Endocrinol. 2013 Aug;9(2):86-91. doi: 10.17925/EE.2013.09.02.86. Epub 2013 Aug 23.
With the rapid increase in obesity there has been a pronounced increase in obesity-related metabolic disorders including type 2 diabetes, cardiovascular disease, dyslipidaemia and hypertension. Bariatric surgery is a highly effective treatment for achieving long-term weight loss and is increasingly recognised to have benefits in diabetes treatment and cause improvement in other metabolic factors. Recent small randomised trials reported better glycaemic control after surgical intervention compared to pharmacological therapy. Physiological studies suggest a surgery-specific, weight-independent effect on glucose homeostasis. Long-term efficacy is to be proven. Consensus on definition of diabetes and diabetes remission must be achieved. Larger multicentre, randomised trials need to be done to clarify the place of metabolic surgery in diabetes treatment algorithms.
随着肥胖率的迅速上升，与肥胖相关的代谢紊乱显著增加，包括2型糖尿病、心血管疾病、血脂异常和高血压。减肥手术是实现长期体重减轻的一种高效治疗方法，并且越来越被认为在糖尿病治疗中有益，还能改善其他代谢因素。最近的小型随机试验报告称，与药物治疗相比，手术干预后血糖控制更好。生理学研究表明，手术对葡萄糖稳态有特定于手术、与体重无关的影响。长期疗效有待证实。必须就糖尿病的定义和糖尿病缓解达成共识。需要开展更大规模的多中心随机试验，以明确代谢手术在糖尿病治疗方案中的地位。
