Abstract
Type 2 diabetes mellitus is a progressive disease owing to gradual decline of insulin secretion. In contrast, insulin resistance remains relatively constant throughout diabetes duration with the exception of patients with more pronounced weight gain.
In many patients, in particular those with continuous weight gain, both progression of insulin resistance and decline of insulin secretion represent a significant problem. In many obese diabetic patients, combination of lifestyle measures and intensive pharmacotherapy fails to achieve satisfactory compensation thus increasing the risk of micro- and macrovascular complications.
For a number of such patients, surgical treatment of obesity and diabetes may represent an appropriate optiion. In this review, we summarize current possibilities of the use of bariatric surgery in the treatment of obesity and type 2 diabetes mellitus with a focus on practical aspects such as an appropriate selection of patient and a suitable type of surgery, pre-operative preparation and the postoperative follow-up.