Gastrointestinal surgery as treatment for type 2 diabetes

Purpose of review As the incidence of type 2 diabetes continues to rise worldwide at epidemic proportions, endeavors to find more effective therapies increase. Gastrointestinal bypass surgery is now gaining awareness as a potential effective and long-term treatment. Recent findings There is now a substantial body of evidence supporting the efficacy of gastrointestinal surgery in controlling type 2 diabetes. This is well documented in several studies of obese diabetic patients undergoing gastrointestinal bypass procedures. Additionally, smaller studies and case reports also demonstrate the efficacy of gastrointestinal bypass surgery in nonobese diabetic patients. The pathophysiologic basis of the improvement in diabetes after gastrointestinal bypass surgery is still unclear; however, the dominant hypotheses involve changes in hormone signaling from the small bowel. Summary The implications of 'diabetes surgery' are vast, and could dramatically change the face of diabetes as we know it today. In clinical practice surgery could represent an alternative for the treatment of diabetes. On a broader perspective, surgery may facilitate research aimed at understanding the etiology of the disease.