The role of metabolic surgery in the treatment of patients with type 2 diabetes mellitus

The results of numerous studies have demonstrated the high effectiveness of bariatric surgery in patients with obesity and type 2 diabetes mellitus (DM). Currently, surgery is one of the most effective ways to decrease body mass, to maintain long-term weight loss and to manage type 2 DM. Particular interest has been generated by the strong positive influence of bariatric surgical interventions on the disruption of carbohydrate metabolism in patients who undergo surgery. This change leads to an improvement in the course of type 2 DM as well as its full remission. This review presents information on the mechanisms associated with glycaemic control improvement in obese patients following the bariatric surgery. This review also contains a comparative analysis of effect of various surgical interventions on DM course, the reasons for postbariatric glycaemia and predictors of the effectiveness of bariatric surgeries in terms of metabolic control in obese patients with type 2 DM. In addition, some information concerning surgical and metabolic complications of bariatric surgical intervention is provided, which needs balanced approach to the treatment method choice.