Purpose of Technology: Roux-en-Y gastric bypass (RYGB) is surgery that reduces the capacity of the stomach and the length of the small intestine through which food travels. RYGB is widely accepted as very effective for weight loss in people with morbid obesity; however, recent research has explored the use of RYGB for the treatment of type II diabetes, including in less obese patients.
Rationale: In addition to being an effective form of weight loss for severely obese patients, bariatric surgery has been linked to significant improvements or complete resolution of obesity-associated comorbidities, including Type II diabetes mellitus (T2DM), in most patients. Researchers generally concur that the mechanism for T2DM is not due to weight loss alone, because improvement is often observed soon after surgery. The term “metabolic surgery” replaces the term “bariatric surgery” when the primary surgical intent is to treat T2DM.
Controversy: RYGB is widely accepted as an effective bariatric surgery for weight loss among people with morbid obesity, but its long-term effects on T2DM resolution and use in less obese individuals (BMI < 35 kilograms per square meter [kg/m2]) are less well understood.
- Is RYGB effective for the treatment of T2DM in terms of diabetes remission or improvement and prevention of diabetes-related complications? Do improvements endure long term?
- How does RYGB compare with intensive medical treatment programs for T2DM?
- What complications are associated with RYGB and medical treatment in patients with T2DM?
- Have definitive patient selection criteria been established for RYGB in patients with T2DM?
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