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减重手术后 2 型糖尿病的缓解:事实还是虚构?

Remission of Type 2 Diabetes Mellitus after Bariatric Surgery: Fact or Fiction?

机构信息

First Department of Propaedeutic Internal Medicine and Diabetes Center, Medical School, National and Kapodistrian University of Athens, Laiko General Hospital, Athens 11527, Greece.

出版信息

Int J Environ Res Public Health. 2019 Aug 30;16(17):3171. doi: 10.3390/ijerph16173171.

Abstract

Although type 2 diabetes mellitus (T2DM) has been traditionally viewed as an intractable chronic medical condition, accumulating evidence points towards the notion that a complete remission of T2DM is feasible following a choice of medical and/or surgical interventions. This has been paralleled by increasing interest in the establishment of a universal definition for T2DM remission which, under given circumstances, could be considered equivalent to a "cure". The efficacy of bariatric surgery in particular for achieving glycemic control has highlighted surgery as a candidate curative intervention for T2DM. Herein, available evidence regarding available surgical modalities and the mechanisms that drive metabolic amelioration after bariatric surgery are reviewed. Furthermore, reports from observational and randomized studies with regard to T2DM remission are reviewed, along with concepts relevant to the variety of definitions used for T2DM remission and other potential sources of discrepancy in success rates among different studies.

摘要

尽管 2 型糖尿病(T2DM)传统上被视为一种难以治愈的慢性疾病,但越来越多的证据表明,通过选择医学和/或手术干预,T2DM 是可以完全缓解的。这与人们对建立 T2DM 缓解的通用定义的兴趣日益增加是一致的,在特定情况下,这种定义可以被认为等同于“治愈”。特别是减重手术在实现血糖控制方面的疗效,突出了手术作为 T2DM 有希望的治愈干预手段的地位。本文回顾了现有的手术方式和减重手术后代谢改善的机制的相关证据。此外,还对观察性和随机研究中关于 T2DM 缓解的报告进行了回顾,同时还讨论了与 T2DM 缓解的各种定义以及不同研究之间成功率差异的其他潜在来源相关的概念。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/653d/6747427/6b18dfd86516/ijerph-16-03171-g001.jpg

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