Clinical considerations for the management of residual diabetes following bariatric surgery. Review uri icon

Overview

abstract

  • Residual diabetes following bariatric surgery is increasingly recognized despite initial weight loss. It occurs more commonly following banding and sleeve gastrectomy procedures than with gastric bypass, is associated with long duration and advanced stages of diabetes and is exacerbated by weight regain. Long-term diabetes management following various gastric restrictive surgery (i.e. lap banding) requires targeting weight loss, insulin resistance and insulin secretion defects with antidiabetic agents that have weight negative or neutral effects. In contrast, re-emergence of hyperglycaemia following gastric bypass may require targeting β-cell failure with insulin analogues. Revisional bariatric surgery is also a consideration. On the basis of our experience, we propose a clinical approach for long-term management of diabetes following various bariatric procedures in the presence and absence of weight regain that is based on recognized pathophysiological effects of these procedures on diabetes remission.

publication date

  • February 21, 2012

Research

keywords

  • Bariatric Surgery
  • Diabetes Mellitus, Type 2
  • Hypoglycemic Agents
  • Obesity, Morbid

Identity

Scopus Document Identifier

  • 84864361986

Digital Object Identifier (DOI)

  • 10.1111/j.1463-1326.2012.01577.x

PubMed ID

  • 22288474

Additional Document Info

volume

  • 14

issue

  • 9