With the rise of obesity there has been a concomitant increase in the incidence of type 2
diabetes (T2DM). As a result, the term “diabesity” has become a popular disease entity in the past
several years. When lifestyle modification and pharmacotherapy fail to achieve successful weight loss
and diabetes control, bariatric surgery is a recommended treatment option. Bariatric surgery has been
shown to promote sustained T2DM remission in 30–63% of patients and improve other components
of metabolic syndrome; thus a preferred term has been “metabolic surgery”. As the practice of bariatric
surgery for the treatment of T2DM increases, so will the number of patients with T2DM not
achieving remission or with T2DM recurrence. There are currently no clear evidence-based guidelines
delineating the proper management of T2DM in post-bariatric surgery patients. The focus of this review
is to discuss current data on the efficacy of bariatric surgery in promoting T2DM remission, factors
that predict T2DM remission and recurrence, and current treatment options for persistent hyperglycemia
in post-bariatric surgery patients. To increase long-term T2DM remission and prevent or delay
recurrence, post-bariatric surgery patients need close follow up to encourage adherence to healthy
nutrition and lifestyle practices that will lead to sustained weight loss. In addition to this, patients need
adequate nutritional supplementation and periodic screening for vitamin, mineral and protein deficiencies.
Therefore, we will conclude with a brief review of current recommendations for nutritional
deficiency screening and supplementation.
Keywords: Bariatric surgery, diabetes remission, partial diabetes remission, nutritional deficiencies, obesity.
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