ABSTRACT
Mechanistic research shows that gastrointestinal (GI) operations originally designed for weight loss (bariatric surgery) can also induce weight-independent effects on metabolic regulation and especially glucose homeostasis, providing a biological rationale for repurposing bariatric surgery as an intentional treatment for type 2 diabetes, a practice referred to as metabolic surgery. A large body of clinical evidence, including numerous randomized trials, shows that metabolic surgery can induce lasting remission of diabetes, reduce cardiometabolic risk and diabetes-related complications, and improve long-term survival and quality of life. Based on such evidence, metabolic surgery has become a standard of care treatment option for type 2 diabetes. This chapter summarizes current evidence and indications to surgical treatment of diabetes.
