Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.632
Peer-review started: December 17, 2022
First decision: March 24, 2023
Revised: April 1, 2023
Accepted: April 24, 2023
Article in press: April 24, 2023
Published online: June 15, 2023
Processing time: 179 Days and 23.3 Hours
Obesity and type-2 diabetes mellitus (T2DM) are metabolic disorders. Obesity increases the risk of T2DM, and as obesity is becoming increasingly common, more individuals suffer from T2DM, which poses a considerable burden on health systems. Traditionally, pharmaceutical therapy together with lifestyle changes is used to treat obesity and T2DM to decrease the incidence of comorbidities and all-cause mortality and to increase life expectancy. Bariatric surgery is increasingly replacing other forms of treatment of morbid obesity, especially in patients with refractory obesity, owing to its many benefits including good long-term outcomes and almost no weight regain. The bariatric surgery options have markedly changed recently, and laparoscopic sleeve gastrectomy (LSG) is gradually gaining popularity. LSG has become an effective and safe treatment for type-2 diabetes and morbid obesity, with a high cost-benefit ratio. Here, we review the me-chanism associated with LSG treatment of T2DM, and we discuss clinical studies and animal experiments with regard to gastrointestinal hormones, gut microbiota, bile acids, and adipokines to clarify current treatment modalities for patients with obesity and T2DM.
Core Tip: Obesity and type-2 diabetes mellitus (T2DM) incidence are currently increasing, and these afflictions have become important global health issues. Bariatric surgery is safe and effective for treating obesity and T2DM. The precise processes associated with this treatment, however, are somewhat unclear. Here, we review associated findings with respect to gastrointestinal hormones, intestinal microbiota, bile acids, and adipokines involved in laparoscopic sleeve gastrectomy (the most popular bariatric surgery) of T2DM patients.