M A Stefater1, T H Inge2. 1. Division of Endocrinology, Boston Children's Hospital, Endocrinology CLS160.4 BCH3151, 300 Longwood Ave., Boston, MA, 02115, USA. margaret.stefater@childrens.harvard.edu. 2. Department of Surgery, Children's Hospital Colorado, 13123 East 16th Avenue, Box 323, Aurora, CO, 80045-7106, USA.
Abstract
PURPOSE OF REVIEW: Type 2 diabetes (T2D) is a growing public health problem in youth, but conventional treatments are often insufficient to treat this disease and its comorbidities. We review evidence supporting an emerging role for bariatric surgery as a treatment for adolescent T2D. RECENT FINDINGS: Paralleling what has been seen in adult patients, bariatric surgery dramatically improves glycemic control in patients with T2D. In fact, remission of T2D has been observed in as many as 95-100% of adolescents with diabetes after bariatric surgery, particularly vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) surgery. This striking outcome may be due to both weight-dependent- and weight-independent factors, and recent studies suggest that T2D-related comorbidities may also improve after surgery. Bariatric surgery including RYGB and VSG is a powerful therapeutic option for obese adolescents with T2D. Benefits must be weighed against risk for postoperative complications such as nutritional deficiencies, but earlier surgical intervention might lead to more complete metabolic remission in obese patients with T2D.
PURPOSE OF REVIEW: Type 2 diabetes (T2D) is a growing public health problem in youth, but conventional treatments are often insufficient to treat this disease and its comorbidities. We review evidence supporting an emerging role for bariatric surgery as a treatment for adolescent T2D. RECENT FINDINGS: Paralleling what has been seen in adult patients, bariatric surgery dramatically improves glycemic control in patients with T2D. In fact, remission of T2D has been observed in as many as 95-100% of adolescents with diabetes after bariatric surgery, particularly vertical sleeve gastrectomy (VSG) and Roux-en-Y gastric bypass (RYGB) surgery. This striking outcome may be due to both weight-dependent- and weight-independent factors, and recent studies suggest that T2D-related comorbidities may also improve after surgery. Bariatric surgery including RYGB and VSG is a powerful therapeutic option for obese adolescents with T2D. Benefits must be weighed against risk for postoperative complications such as nutritional deficiencies, but earlier surgical intervention might lead to more complete metabolic remission in obesepatients with T2D.
Authors: Alexander Towbin; Thomas H Inge; Victor F Garcia; Helmut R Roehrig; Ronald H Clements; Carroll M Harmon; Stephen R Daniels Journal: J Pediatr Date: 2004-08 Impact factor: 4.406
Authors: C Poitou Bernert; C Ciangura; M Coupaye; S Czernichow; J L Bouillot; A Basdevant Journal: Diabetes Metab Date: 2007-01-26 Impact factor: 6.041
Authors: Philip R Schauer; Deepak L Bhatt; John P Kirwan; Kathy Wolski; Stacy A Brethauer; Sankar D Navaneethan; Ali Aminian; Claire E Pothier; Esther S H Kim; Steven E Nissen; Sangeeta R Kashyap Journal: N Engl J Med Date: 2014-03-31 Impact factor: 91.245
Authors: Anita P Courcoulas; Steven H Belle; Rebecca H Neiberg; Sheila K Pierson; Jessie K Eagleton; Melissa A Kalarchian; James P DeLany; Wei Lang; John M Jakicic Journal: JAMA Surg Date: 2015-10 Impact factor: 14.766
Authors: Francesco Rubino; David M Nathan; Robert H Eckel; Philip R Schauer; K George M M Alberti; Paul Z Zimmet; Stefano Del Prato; Linong Ji; Shaukat M Sadikot; William H Herman; Stephanie A Amiel; Lee M Kaplan; Gaspar Taroncher-Oldenburg; David E Cummings Journal: Surg Obes Relat Dis Date: 2016-07 Impact factor: 4.734
Authors: Lena M S Carlsson; Kajsa Sjöholm; Cecilia Karlsson; Peter Jacobson; Johanna C Andersson-Assarsson; Per-Arne Svensson; Ingrid Larsson; Stephan Hjorth; Martin Neovius; Magdalena Taube; Björn Carlsson; Markku Peltonen Journal: Lancet Diabetes Endocrinol Date: 2017-02-23 Impact factor: 32.069
Authors: Sarah B Ogle; Lindel C Dewberry; Todd M Jenkins; Thomas H Inge; Megan Kelsey; Matias Bruzoni; Janey S A Pratt Journal: Pediatrics Date: 2021-02-01 Impact factor: 7.124