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Incretins, diabetes, and bariatric surgery: a review

The prevalence of type 2 diabetes mellitus is increasing rapidly in the United States, with almost 16 million adults currently affected [1] . Obesity is an independent risk factor for diabetes. Among diabetic individuals, 50% are obese, with a body mass index (BMI) > 30 kg/m 2 [1] . Bariatric surgery (surgical weight loss) has become an effective treatment for morbid obesity in those patients who have failed medical management of their illness. Up to 30% of patients presenting for bariatric surgery have type 2 diabetes mellitus [2,3] . The most commonly performed surgical procedure for weight loss, the Roux-en- Y gastric bypass (GBP), results in a percentage of excess weight loss (%EWL) of 50% to 75% and “cures” diabetes in 70% to 100% of patients [2,4] by improving both insulin secretion and sensitivity [5] . The possible role of the gut hormones known as incretins in the improvement of diabetes after bariatric surgery has been hypothesized. The incretins, gut peptides secreted in response to meals, enhance insulin secretion. The impaired incretin secretion in obese type 2 diabetes mellitus is partially responsible for the defect in insulin secretion [6–9] . In this article we review the role of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Surgery for Obesity and Related Diseases Elsevier
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