Evalution of the glycemic profile of patientis undergoing bariatric surgery literature review

Abstract

Obesity is a global epidemic that affects billions of adults, impacting the development of several diseases such as Type 2 Diabetes Mellitus (DM2), high blood pressure, dyslipidemia, cancer and kidney disease. It is postulated that changes in lipid and glucose metabolism, linked to overweight and obesity, can trigger insulin resistance, cellular dysfunction and T2DM. Considering the large number of obese and overweight individuals with T2DM, the Brazilian Federal Council of Medicine recognizes the importance of bariatric surgery for the treatment of patients with DM2. Bariatric surgery is recommended as an anti-obesity treatment for patients between the ages of 18 and 65, with a body mass index (BMI) greater than 40 or greater than 35 kg/m² associated with severe comorbidities and refractory to non-pharmacological and pharmacological treatment. This literature review study aims to evaluate the effect of bariatric surgery, using the gastric bypass method, on fasting blood glucose and plasma glycated hemoglobin (HbA1c) concentration in patients with a previous diagnosis of diabetes. A total of 1053 individuals aged 40.00 to 53.00 years were analyzed in the postoperative periods of 0.5, 1, 2, 3, 4 and 5 years. The mean blood glucose (187.05 ± 30.90 mg/dL) and HbA1c (8.58 ± 0.92%) values found in the pre-surgical stage, compatible with diabetes, decreased to the pre-diabetes range, respectively, to mean values of 109.33 mg/dL and 6.25% after one year of surgery. Over the years, the reduction in glycemic parameters was smaller. In this context, it can be considered that the reduction of obesity through the bariatric surgery technique by bypass provided partial remission of DM2.