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

IF 4.2 3区 医学 Q1 ENDOCRINOLOGY & METABOLISM
Ryan J Jalleh, Karen L Jones, Md Shahidul Islam, Lu Cai, Michael Horowitz
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引用次数: 0

Abstract

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.

肥胖相关 2 型糖尿病的手术或药物治疗--一个日益严重的临床难题。
在这篇社论中,我们对 He 等人的文章进行了评论,特别是关于减肥手术与胰高血糖素样肽-1 受体激动剂(GLP-1RA)疗法在治疗与肥胖相关的 2 型糖尿病(T2D)方面的疗效。目前,减肥手术已被证明对患有肥胖症和 T2D 的青少年是安全有效的,但有关新型 GLP-1RA 在这些人群中的应用的信息却十分有限。对于老年人(年龄大于 65 岁),减肥手术和 GLP-1RA 治疗都能改善心血管预后。减肥手术通常会导致术后餐后低血糖,而 GLP-1RAs 却不会出现这种情况,矛盾的是,有证据表明 GLP-1RAs 可以降低餐后低血糖的发生频率和严重程度。有必要对减肥手术和 GLP-1RA 的长期疗效进行比较试验。
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来源期刊
World Journal of Diabetes
World Journal of Diabetes ENDOCRINOLOGY & METABOLISM-
自引率
2.40%
发文量
909
期刊介绍: The WJD is a high-quality, peer reviewed, open-access journal. The primary task of WJD is to rapidly publish high-quality original articles, reviews, editorials, and case reports in the field of diabetes. In order to promote productive academic communication, the peer review process for the WJD is transparent; to this end, all published manuscripts are accompanied by the anonymized reviewers’ comments as well as the authors’ responses. The primary aims of the WJD are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in diabetes. Scope: Diabetes Complications, Experimental Diabetes Mellitus, Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus, Diabetes, Gestational, Diabetic Angiopathies, Diabetic Cardiomyopathies, Diabetic Coma, Diabetic Ketoacidosis, Diabetic Nephropathies, Diabetic Neuropathies, Donohue Syndrome, Fetal Macrosomia, and Prediabetic State.
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