Mechanisms Responsible for Metabolic Improvements of Bariatric Surgeries.

Abstract

Given the seemingly unstoppable diabetes crisis, new efficient therapies for the prevention and treatment of this devastating and costly disease are sorely needed, and bariatric surgeries intended for weight loss seem to fill this gap. In addition to weight loss, there is remarkable short- to medium-term diabetes remission, particularly after Roux-en-Y gastric bypass and sleeve gastrectomy (1). However, broad longer-term effectiveness and complete cure are more elusive (2,3). It is also clear that bariatric surgery is not the answer for the staggering numbers of people with obesity and type 2 diabetes on either a national or global scale. This, in turn, has stimulated intense research efforts to find out the molecular and behavioral mechanisms behind the success of bariatric surgeries so that they can eventually be exploited with improved pharmacological and lifestyle/behavioral strategies but without the surgery. The question of whether diabetes remission is mainly due to weight loss or weight loss–independent effects of the surgery is fundamental, as it guides experimental approaches and may lead us to very different sets of key underlying pathways …