Cardiovascular Effects of Metabolic Surgery on Type 2 Diabetes

Abstract

Introduction: Cardiovascular, together with renal disease, claims a significant proportion of morbidity and mortality in association with type 2 diabetes mellitus (T2DM) and obesity. To improve on the long-term renal and cardiovascular outcome, there is the incorporation of bariatric surgery (BS), which seems to be a pivotal intervention. Areas explored: Cohort studies and randomized controlled trial (RCT) research of BS among patients with T2DM, are investigated by screening, then information on renal effects and cardiovascular outcome gathered. Metabolic surgery (MS) and BS reduce both mortality and the risk of cardiovascular disorder, chronic kidney diseases and albuminuria. MS refers to a surgical approach whose primary intent is the control of metabolic alterations/hyperglycemia in contrast to BS which is a mere weight-reduction therapy. Patients suffering from poor glycaemic control and other macro and micro-vascular diseases will benefit from a surgical approach. The approach implicates hypertension glomerular remission, gut microbiota shift, reduced renal inflammation and fewer instances of chronic cardiac remodelling. Conclusion: MS is beneficial where the main aim is to attain a significant and long-lasting weight loss results. The RCTs have depicted the superiority which surgical mechanisms hold over medically based therapy, for enhancing glycaemic control, and achieving remission of diabetes. This type of surgery improves life quality, reduces incidences of other obesity and diabetes relating diseases like microvascular illness, sleep apnea, fatal disorder, and fatty liver disease.

Effects of β-carotene on glucose metabolism dysfunction in humans and type 2 diabetic rats

“…Peroxide and other ROS produced in vascular cells may play important roles in the pathogenesis of common vascular diseases [30,31], particularly diabetes. Longterm clinical observational studies on diabetes have revealed that, in addition to metabolic toxicity factors, protective factors may also protect the function and survival of cells involved in microvascular diseases through influencing blood glucose control [32][33][34]. Therefore, we also examined cardiac microvascular recruitment on the basis of the diastolic/systolic stress MBF ratio, as a novel diagnostic index with moderate diagnostic accuracy [35].…”

The Impact of Diabetes Type 2 Treatment Interventions on Cardiovascular Outcomes – A Comprehensive Review

“…Bariatric surgery (BS) or metabolic surgery (MS) has emerged in the last decades as a treatment for obesity and diabetes for better life quality control by dramatically reducing weight and improving glycemic control, lipid profile, and BP [98]. There is strong and consistent evidence that obesity management can delay the progression from prediabetes to type 2 diabetes [99,100] and is highly beneficial in treating type 2 diabetes [101,102]. In people with type 2 diabetes and overweight or obesity, modest weight loss improves glycemia and reduces the need for glucoselowering medications [101][102][103], and larger weight loss substantially reduces A1C and fasting glucose and has been shown to promote sustained diabetes remission through at least 2 years.…”

Diabetes Mellitus: An Update

“…Bariatric surgery including procedures like Roux-en-Y Gastric Bypass, Sleeve Gastrectomy, Laparoscopic Adjustable Gastric Banding as it is summarized by Damaskos et al . [ 9 , 10 ]. This approach improves clinically appropriate endpoints that include the remission of various comorbidities and the lowering of cardiovascular risks together with serious cardiovascular events but the emphasis should be given on appropriate patient selection with a long-term period of follow-up [ 11 ].…”