Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Nov 15, 2024; 15(11): 2157-2161
Published online Nov 15, 2024. doi: 10.4239/wjd.v15.i11.2157
Diabetes and obesity: A debate on bariatric interventions and its implications
José C Tatmatsu-Rocha, Marcos R Lima da Silva
José C Tatmatsu-Rocha, Marcos R Lima da Silva, College of Medicine, Postgraduate Program in Physiotherapy and Functionality, Department of Physiotherapy, Federal University of Ceará-UFC, Fortaleza 60430-450, Ceará, Brazil
Author contributions: Tatmatsu-Rocha JC and Lima da Silva MR contributed to writing and editing the manuscript and reviewing the literature; Tatmatsu-Rocha JC designed the overall concept and draft of the manuscript; Lima da Silva MR contributed to the discussion and conception of the manuscript; Lima da Silva MR revised the final version of the manuscript.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed by the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: José C Tatmatsu-Rocha, MSc, PhD, Professor, Research Scientist, College of Medicine, Postgraduate Program in Physiotherapy and Functionality, Department of Physiotherapy, Federal University of Ceará-UFC, Rua Major Weyne, 1440, Fortaleza 60430-450, Ceará, Brazil. tatmatsu@ufc.br
Received: April 3, 2024
Revised: August 29, 2024
Accepted: September 26, 2024
Published online: November 15, 2024
Processing time: 195 Days and 21 Hours
Abstract

In this editorial, we comment on an article by Tang et al published in the World Journal of Diabetes. Obesity and diabetes are two pathological situations that are intrinsically related. Neither lifestyle changes nor pharmacological treatments have achieved diabetes remission. From this perspective, bariatric surgery has been widely used as an approach for weight loss in obese patients and as a strategy to promote metabolic modulation. The main effects of bariatric surgery involve direct action in improving cardiovascular function and endothelial function and reducing insulin resistance, leading to diabetes remission in the short term following surgery. In this context, it has been observed that hormones from the gastrointestinal tract and endothelium play a prominent role in this process. By reversing endothelial dysfunction, it is possible to balance pro-inflammatory cytokine production, improving the availability of nitric oxide and inhibiting vascular oxidative stress. Furthermore, it can be considered an efficient anti-inflammatory strategy, alleviating interferon-gamma-mediated adipose tissue inflammation. The current challenge must be to unravel the pathophysiological mechanisms and potential targets for treating metabolic diseases.

Keywords: Bariatric surgery; Diabetes mellitus; Oxidative stress; Endothelial dysfunction; Obesity

Core Tip: In this editorial, we address the pathophysiological mechanisms associated with bariatric surgery in type 2 diabetes remission. Within this perspective, we discuss gastrointestinal tract hormones, mainly peptide-1, which is a hormone secreted by gastrointestinal L cells and released immediately after food intake, as well as the benefits obtained after reversing endothelial syndrome via bariatric surgery.