Over the last decade, obesity rates have continued to rise in the United States as well as worldwide and are showing no signs of slowing down. This rise is in parallel with the increasing rates of type 2 diabetes mellitus (T2DM). Given the association between obesity and T2DM and their strong correlation with increased morbidity and mortality in addition to healthcare expenditure, it is important to recognize the most effective ways to combat them. Thus, we performed a review of literature that focused on assessing the outcomes of T2DM following bariatric surgery. Available evidence suggests that bariatric surgery provides better T2DM resolution in obese patients when compared to best medical management alone. Additionally, Biliopancreatic diversion with duodenal switch as well as Roux-en-Y gastric bypass have demonstrated higher rates of T2DM resolution when compared with other bariatric procedures.
Over the last decade, sleeve gastrectomy (SG) has steadily gained popularity and has now become the most commonly performed bariatric procedure in the United States. It is technically less complex than Roux-en-Y gastric bypass (RYGB) or biliopancreatic diversion with duodenal switch and has relatively good weight loss results in addition to comorbidity resolution. The long-term complication profile is appealing to patients and surgeons alike, save one issue, gastroesophageal reflux disease (GERD). GERD is frequently seen in bariatric surgery patients; thus, proper patient selection for SG is paramount. However, SG effects on GERD remain controversial in the literature. Thus, patients are intensively cautioned of the possibility of de novo GERD or worsening of already existing GERD following SG. Therefore, it is imperative that the discussion also occurs regarding potential treatment options if GERD does occur. GERD management following SG consists of a multitude of options. While lifestyle modifications and proton pump inhibitors remain the initial treatment of choice, some will have persistent symptoms needing additional interventions, which may range from a variety of endoscopic techniques (lower esophageal sphincter [LES], radiofrequency ablation, magnetic LES augmentation, and antireflux mucosectomy) to ReSleeve and ultimately conversion to RYGB.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.