Hormonal
Biliopancreatic diversion (BPD) and its modifications (BPD-DS, SADI) induce rapid remission of type 2 diabetes (T2D) and normalize lipid profiles, largely through hormonal mechanisms (increased GLP-1, decreased ghrelin) that occur independently of significant weight loss.
For patients with severe obesity and Type 2 Diabetes, surgical options like BPD-DS or SADI are highly effective at inducing diabetes remission (often >90%), frequently independent of immediate weight loss. This is driven by hormonal shifts (increased GLP-1, decreased ghrelin) caused by bypassing parts of the small intestine. While effective, these procedures require lifelong medical monitoring and vitamin supplementation to manage malabsorption risks.
В большинстве случаев ремиссия наблюдается уже через несколько дней или недель после операции, до того, как наступит значимое снижение массы тела [61]. Этот эффект был продемонстрирован и в экспериментальном исследовании на крысах Goto-Kaki zaki (GK)... выключение двенадцатиперстной кишки и начального отдела тощей кишки значительно улучшает показатели гликемии натощак и толерантность к глюкозе вне зависимости от потери массы тела и/или уменьшения количества поглощенных калорий.
Why this rating
Based on large retrospective cohorts (up to 3250 patients) and long-term follow-up (up to 30 years), though not a randomized controlled trial.
Source
Evolution of biliopancreatic diversion in the treatment of morbid obesity and type 2 diabetes mellitus
Н.С. Бордан et al. · Diabetes Mellitus · 2016
DOI 10.14341/7928
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