Hormonal
Roux-en-Y gastric bypass (RYGB) induces significant remission of Type 2 Diabetes (T2DM) and Systemic Arterial Hypertension (SAH) in obese patients, largely through neuroendocrine mechanisms involving GLP-1 and bile acids, independent of or in addition to weight loss.
For obese patients with difficult-to-control diabetes or hypertension, Roux-en-Y gastric bypass is a highly effective treatment that can lead to disease remission. This benefit is driven by hormonal changes in the gut (GLP-1 and bile acids) that improve metabolic control, not just by weight loss. While lifestyle changes are the first line of defense, they often fail to sustain control, making surgery a viable option for eligible candidates.
This is due to changes in neuroendocrine mechanisms mediated by glucagon-like peptide 1 (GLP-1) and changes in intestinal physiology, exerting a regulatory effect under glycemic control, regardless of weight loss
Why this rating
Retrospective cohort study with a large sample size (n=252) but limited follow-up (2 years) and lack of a concurrent control group for the specific surgical vs. medical comparison within the study itself.
Source
The effect of Roux-en-Y gastric bypass in the treatment of hypertension and diabetes
Giulia Marchetti et al. · Revista do Colégio Brasileiro de Cirurgiões · 2020
DOI 10.1590/0100-6991e-20202655
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