Indicaciones de la cirugía bariátrica en sujetos con diabetes mellitus tipo 2

Remission of type 2 diabetes or a marked improvement of the metabolic control could be accomplished after bariatric surgery. Most endocrinologists are reluctant to recommend bariatric surgery to type 2 diabetic patients with a BMI > 35 kg/m2 based on: lack of high quality data, perception that surgery offers nothing but a motivation to change the unhealthy lifestyle habits, and inherent risks of bariatric surgery. In contrast, from the surgeon's perspective, type 2 diabetes is a surgical disease irrespective of the BMI prior to surgery. In this review, we discuss the available data on the diabetes outcomes for patients with a BMI above or below the 35 kg/m2 threshold. Data would suggest that bariatric surgery should be considered as an option in the therapeutic algorithm of the type 2 diabetic patient with a BMI > 35 kg/m2. Given the expanding nature of the type 2 diabetes epidemics, it is very unlikely that surgery will become the treatment of choice for type 2 diabetes. Nonetheless, future studies should demonstrate if it could be also a valuable tool also for selected patients with a BMI between 30 and 35 kg/m2.