Surgical or medical treatment of obesity-associated type 2 diabetes-an increasing clinical conundrum

被引:0
作者
Jalleh, Ryan J. [1 ,2 ,3 ]
Jones, Karen L. [1 ,2 ,3 ]
Islam, Md Shahidul [4 ]
Cai, Lu [5 ]
Horowitz, Michael [1 ,2 ,3 ]
机构
[1] Univ Adelaide, Adelaide Med Sch, Level 5,AHMS Corner North Tce & George St, Adelaide 5000, Australia
[2] Univ Adelaide, Ctr Res Excellence Translating Nutr Sci Good Hlth, Adelaide, Australia
[3] Royal Adelaide Hosp, Endocrine & Metab Unit, Adelaide, SA 5000, Australia
[4] Univ KwaZulu Natal, Sch Life Sci, Dept Biochem, ZA-4000 Durban, South Africa
[5] Univ Louisville, Norton Childrens Hosp, Wendy Novak Diabet Inst, Pediat Res Inst,Div Endocrinol,Dept Pediat,Radiat, Louisville, KY 40202 USA
关键词
Glucagon-like peptide-1; Glucagon-like peptide-1 receptor agonist; Obesity; Diabetes; Weight loss; Bariatric surgery; Metabolic surgery; Hypoglycemia; BARIATRIC SURGERY; DOUBLE-BLIND; LIRAGLUTIDE; PLACEBO; WEIGHT; GLP-1; GLIMEPIRIDE; MANAGEMENT; METFORMIN; EFFICACY;
D O I
10.4239/wjd.v15.i10.2036
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In this editorial, we comment on the article by He et al, specifically in relation to the efficacy of bariatric surgery vs glucagon-like peptide-1 receptor agonist (GLP-1RA) therapy in the management of type 2 diabetes (T2D) associated with obesity. Bariatric surgery has now also been shown to be safe and effective in pre-teens and teenagers with obesity and T2D, but information on newer GLP-1RAs in these groups is predictably limited. In older individuals (age > 65 years), both bariatric surgery and GLP-1RA therapy improve cardiovascular outcomes. Bariatric surgery is not infrequently associated with post-operative postprandial hypoglycemia, which is not the case with GLP-1RAs and, paradoxically, there is evidence that GLP-1RAs may reduce both the frequency and severity of postprandial hypoglycemia. Comparative trials of the long-term efficacy of bariatric surgery and GLP-1RAs are indicated.
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页数:6
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