Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery
Type 2 diabetes prevalence is increasing dramatically worldwide. Metabolic surgery is the most effective treatment for selected patients with diabetes and/or obesity. When compared to intensive medical therapy and lifestyle intervention, metabolic surgery has shown superiority in achieving glycemic...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2019-09-01
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| Series: | Frontiers in Endocrinology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fendo.2019.00641/full |
| _version_ | 1818010775850057728 |
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| author | Belén Pérez-Pevida Belén Pérez-Pevida Javier Escalada Javier Escalada Javier Escalada Alexander D. Miras Gema Frühbeck Gema Frühbeck Gema Frühbeck |
| author_facet | Belén Pérez-Pevida Belén Pérez-Pevida Javier Escalada Javier Escalada Javier Escalada Alexander D. Miras Gema Frühbeck Gema Frühbeck Gema Frühbeck |
| author_sort | Belén Pérez-Pevida |
| collection | DOAJ |
| description | Type 2 diabetes prevalence is increasing dramatically worldwide. Metabolic surgery is the most effective treatment for selected patients with diabetes and/or obesity. When compared to intensive medical therapy and lifestyle intervention, metabolic surgery has shown superiority in achieving glycemic improvement, reducing number of medications and cardiovascular risk factors, which translates in long-term benefits on cardiovascular morbidity and mortality. The mechanisms underlying diabetes improvement after metabolic surgery have not yet been clearly understood but englobe a complex interaction among improvements in beta cell function and insulin secretion, insulin sensitivity, intestinal gluconeogenesis, changes in glucose utilization, and absorption by the gut and changes in the secretory pattern and morphology of adipose tissue. These are achieved through different mediators which include an enhancement in gut hormones release, especially, glucagon-like peptide 1, changes in bile acids circulation, gut microbiome, and glucose transporters expression. Therefore, this review aims to provide a comprehensive appraisal of what is known so far to better understand the mechanisms through which metabolic surgery improves glycemic control facilitating future research in the field. |
| first_indexed | 2024-04-14T05:59:46Z |
| format | Article |
| id | doaj.art-587eae7438c940b5a4311618affd52dc |
| institution | Directory Open Access Journal |
| issn | 1664-2392 |
| language | English |
| last_indexed | 2024-04-14T05:59:46Z |
| publishDate | 2019-09-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Endocrinology |
| spelling | doaj.art-587eae7438c940b5a4311618affd52dc2022-12-22T02:08:49ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922019-09-011010.3389/fendo.2019.00641418007Mechanisms Underlying Type 2 Diabetes Remission After Metabolic SurgeryBelén Pérez-Pevida0Belén Pérez-Pevida1Javier Escalada2Javier Escalada3Javier Escalada4Alexander D. Miras5Gema Frühbeck6Gema Frühbeck7Gema Frühbeck8Section of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, Hammersmith Campus, London, United KingdomDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, SpainDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, SpainBiomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII, Pamplona, SpainObesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, SpainSection of Investigative Medicine, Division of Diabetes, Endocrinology and Metabolism, Imperial College London, Hammersmith Campus, London, United KingdomDepartment of Endocrinology and Nutrition, Clínica Universidad de Navarra, Pamplona, SpainBiomedical Research Networking Center for Physiopathology of Obesity and Nutrition (CIBEROBN), ISCIII, Pamplona, SpainObesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, SpainType 2 diabetes prevalence is increasing dramatically worldwide. Metabolic surgery is the most effective treatment for selected patients with diabetes and/or obesity. When compared to intensive medical therapy and lifestyle intervention, metabolic surgery has shown superiority in achieving glycemic improvement, reducing number of medications and cardiovascular risk factors, which translates in long-term benefits on cardiovascular morbidity and mortality. The mechanisms underlying diabetes improvement after metabolic surgery have not yet been clearly understood but englobe a complex interaction among improvements in beta cell function and insulin secretion, insulin sensitivity, intestinal gluconeogenesis, changes in glucose utilization, and absorption by the gut and changes in the secretory pattern and morphology of adipose tissue. These are achieved through different mediators which include an enhancement in gut hormones release, especially, glucagon-like peptide 1, changes in bile acids circulation, gut microbiome, and glucose transporters expression. Therefore, this review aims to provide a comprehensive appraisal of what is known so far to better understand the mechanisms through which metabolic surgery improves glycemic control facilitating future research in the field.https://www.frontiersin.org/article/10.3389/fendo.2019.00641/fulltype 2 diabetesbariatric surgeryinsulin resistancebeta-cell functionglucose absorptionglucose utilization |
| spellingShingle | Belén Pérez-Pevida Belén Pérez-Pevida Javier Escalada Javier Escalada Javier Escalada Alexander D. Miras Gema Frühbeck Gema Frühbeck Gema Frühbeck Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery Frontiers in Endocrinology type 2 diabetes bariatric surgery insulin resistance beta-cell function glucose absorption glucose utilization |
| title | Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery |
| title_full | Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery |
| title_fullStr | Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery |
| title_full_unstemmed | Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery |
| title_short | Mechanisms Underlying Type 2 Diabetes Remission After Metabolic Surgery |
| title_sort | mechanisms underlying type 2 diabetes remission after metabolic surgery |
| topic | type 2 diabetes bariatric surgery insulin resistance beta-cell function glucose absorption glucose utilization |
| url | https://www.frontiersin.org/article/10.3389/fendo.2019.00641/full |
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