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Bariatric Surgery: Prevalence, Predictors, and Mechanisms of Diabetes Remission

  • Obesity (J McCaffery, Section Editor)
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Abstract

Type 2 diabetes is a chronic disease that can be treated with pharmacologic and/or lifestyle interventions, but in most cases it does not get cured. One of the few interventions, however, that can remit diabetes is the Roux-en-Y gastric bypass (RYGB) surgery. Approximately 63 % of patients undergoing RYGB surgery experience diabetes remission, but the underlying mechanisms are poorly understood. Some studies implicate enterohepatic pathways with bile acids, fibroblast growth factor 19 (FGF19), and glucagon-like peptide 1 (GLP-1) being the primary components. Here, we discuss these enterohepatic changes and highlight the roles of bile acids, FGF19, and GLP-1 in diabetes remission. We also describe how we can now actually predict, prior to surgery, the probability for remitting diabetes after RYGB surgery by using the DiaRem score. Deeper understanding of the mechanisms of diabetes remission by RYGB surgery could provide the basis for developing more effective interventions for curing the disease.

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Acknowledgments

I would like to thank the thousands of bariatric patients that have participated in various clinical studies.

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Conflict of Interest

George Argyropoulos declares that he has no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Institute of Obesity, Geisinger Health System, 100 North Academy Avenue, Danville, PA, 17822, USA

    George Argyropoulos

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  1. George Argyropoulos
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Correspondence to George Argyropoulos.

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This article is part of the Topical Collection on Obesity

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Argyropoulos, G. Bariatric Surgery: Prevalence, Predictors, and Mechanisms of Diabetes Remission. Curr Diab Rep 15, 15 (2015). https://doi.org/10.1007/s11892-015-0590-9

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