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Journal of Obesity
Volume 2012 (2012), Article ID 147256, 9 pages
http://dx.doi.org/10.1155/2012/147256
Review Article

Review of Metabolic Surgery for Type 2 Diabetes in Patients with a BMI < 35 kg/m2

M61 Cleveland Clinic, Bariatric and Metabolic Institute, 9500 Euclid Avenue, Cleveland, OH 44195, USA

Received 5 January 2012; Accepted 30 March 2012

Academic Editor: R. Prager

Copyright © 2012 Hideharu Shimizu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Bariatric/metabolic surgery is considered an accepted treatment option for type 2 diabetes mellitus (T2DM) with body mass index (BMI)  ≧  35 kg/m2. Mounting evidence also shows that metabolic surgery is effective for T2DM with BMI  <  35 kg/m2. To evaluate current status of metabolic surgery, we reviewed the available clinical studies which described surgical treatment for T2DM with mean BMI  <  35 kg/m2. 18 studies with 477 patients were identified. 30% of the patients was insulin users. The follow-up period ranged from 6 to 216 months. The weight loss effect was reasonable, not excessive. Mean BMI decreased from 30.4 to 24.8 kg/m2. Remission of T2DM was achieved in 64.7% of the patients with fasting plasma glucose and glycated hemoglobin approaching slightly above normal range. Clinical T2DM status was an important factor when selecting the eligible candidates for metabolic surgery. Postoperative complication rate of 10.3% with mortality of 0% in the studies has been acceptable. Even though it would be premature at this point to state that metabolic surgery is an accepted treatment option for T2DM with BMI < 35 kg/m2, it is clear that a high proportion of T2DM patients will derive substantial benefit from metabolic surgery.