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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorHALPERN, Bruno
dc.contributor.authorMANCINI, Marcio Correa
dc.identifier.citationOBESITY REVIEWS, v.20, n.5, p.633-647, 2019
dc.description.abstractBariatric surgery has shifted from being a risky procedure to an evidence-based one, with proven benefits on all-cause mortality, cardiovascular disease, cancer, and diabetes control. The procedure has an overall positive result on type 2 diabetes mellitus (T2DM), with a substantial number of patients achieving disease remission. This has resulted in several studies assessing possible weight-independent effects of bariatric surgery on glycemic improvement, in addition to recommendation of the procedure to patients with class 1 obesity and T2DM, for whom the procedure was classically not indicated, and adoption of a new term, ""metabolic surgery,"" to highlight the overall metabolic benefit of the procedure beyond weight loss. Recently, the Diabetes Surgery Summit (DSS) has included metabolic surgery in its T2DM treatment algorithm. Although the discussion brought by this consensus is highly relevant, the recommendation of metabolic surgery for patients with uncontrolled T2DM and a body mass index of 30 to 35 kg/m(2) still lacks enough evidence. This article provides an overall view of the metabolic benefits of bariatric/metabolic surgery in patients with class 1 obesity, compares the procedure against clinical treatment, and presents our rationale for defending caution on recommending the procedure to less obese individuals.eng
dc.relation.ispartofObesity Reviews
dc.subjectbariatric surgeryeng
dc.subjectclass I obesityeng
dc.subjectmetabolic surgeryeng
dc.subjecttype 2 diabeteseng
dc.subjectweight losseng
dc.subject.othery gastric bypasseng
dc.subject.otherintensive medical therapyeng
dc.subject.otherlife-style interventioneng
dc.subject.otherbody-mass indexeng
dc.subject.otherduodenal-jejunal exclusioneng
dc.subject.otherhigh glycemic variabilityeng
dc.subject.otherobstructive sleep-apneaeng
dc.subject.otherlong-term remissioneng
dc.subject.otherbeta-cell functioneng
dc.subject.otherbariatric surgeryeng
dc.titleMetabolic surgery for the treatment of type 2 diabetes in patients with BMI lower than 35 kg/m(2): Why caution is still neededeng
dc.rights.holderCopyright WILEYeng
dc.subject.wosEndocrinology & Metabolismeng
dc.type.categoryoriginal articleeng
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