Subject    :    [2016 Dec;40(6)] Metabolic Surgery for Type 2 Diabetes Mellitus: Experience from Asia
Writer KDA
Date 2017-01-02 14:21:49 Hit 7,061
Diabetes Metab J. 2016 Dec;40(6):433-443. English.
Published online Dec 02, 2016.  https://doi.org/10.4093/dmj.2016.40.6.433 
Copyright © 2016 Korean Diabetes Association
   
Metabolic Surgery for Type 2 Diabetes Mellitus: Experience from Asia
Wei-Jei Lee,1 and Lwin Aung2
1Department of Surgery, Min-Sheng General Hospital, National Taiwan University, Taoyuan, Taiwan.
2Department of Surgery, Ng Teng Fong General Hospital, Singapore.

Corresponding author: Wei-Jei Lee. Department of Surgery, Min-Sheng General Hospital, National Taiwan University, No 168, Chin Kuo Road, Taoyuan, Taiwan. Email: wjlee_obessurg_tw@yahoo.com.tw 
 
Received September 02, 2016; Accepted October 25, 2016.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract

Type 2 diabetes mellitus (T2DM) is a current global health priority and Asia is the epicenter of this epidemic disease. Unlike in the west, where older population is most affected, the burden of diabetes in Asian countries is disproportionately high in young to middle-age adults. The incidence of diabetic nephropathy is alarmingly high in patients with early onset T2DM, especially in those with poor glycemic control. How to control this chronic and debilitating disease is currently a very important health issue in Asia. Bariatric surgery has proven successful in treating not just obesity but also T2DM in morbid obese patients (body mass index [BMI] >35 kg/m2). Gastrointestinal metabolic surgery recently has been proposed as a new treatment modality for obesity related T2DM for patients with BMI 2. Many studies from Asia reported promising results of metabolic surgery to treat obese patients with T2DM which is not well controlled. It has been demonstrated that changes in gastrointestinal hormone secretion after gastrointestinal surgery would favor an early improvement of T2DM in Asians. New procedures have also been designed and proposed specifically for the treatment of diabetes in Asia. This article examines clinical trial data and accepted algorithms with a view toward elucidating the application of metabolic surgery for the treatment of T2DM in the Asia. We propose a systematic approach to surgical treatment, addressing current evidences, patient selection, procedure of choice, and timing and guideline for new procedures.

   
Keywords:
Asian continental ancestry group; Bariatric surgery; Diabetes mellitus, type 2; Obesity
 

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