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KMID : 1033120140030020025
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대한비만대사외과학회지
2014 Volume.3 No. 2 p.25 ~ p.32
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Effects of Metabolic Surgery on Glucose Homeostasis in Type 2 Diabetes
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Park Young-Suk
Ahn Sang-Hoon
Park Do-Joong
Kim Hyung-Ho
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Abstract
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Metabolic surgery has emerged as the most durable and effective treatment of type 2 diabetes (DM). However, the mechanisms of improvement in glucose homeostasis have yet to be fully elucidated. In this review, we discuss the impact of metabolic surgery on type 2 DM and the mechanisms for improved glycemic control. An important mechanism for improvement in type 2 DM is due to the changes in the secretion pattern of gut-derived hormones which are released by enteroendocrine cells mainly located in distal ileum. However, recently, multiple factors such as proximal small bowel exclusion, bile acid reabsorption, change of intestinal microbiota, have been considered to mediate glycemic homeostasis. The other emerging molecular mechanisms which explain the improvement in peripheral insulin resistance after metabolic surgery are changes in mitochondrial dysfunction and central insulin sensitivity. The understanding of the mechanisms in the glucose homeostasis after metabolic surgery will help in discovery of new targets for type 2 DM therapy, optimizing the surgical techniques, and individualizing the treatment.
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KEYWORD
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Bariatric surgery, Metabolic surgery, Insulin sensitivity, Type 2 diabetes
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