INTRODUCTION: Type 2 diabetes mellitus ( T2DM), is the major cause of mortality worldwide, mainly secondary to cardiovascular events. In spite of the recent advances in the medical treatment, an expressive number of patients remain uncontrolled. Metabolic surgery may open new frontiers to control this devastating disease. AIM: To describe the surgical alternatives to treat surgically T2DM patients, including some proposed mechanisms of action that are behind the metabolic improvement. METHODS: PubMed and Lilacs database were searched according to the following keywords: bariatric surgery, morbid obesity, diabetes mellitus, gastric bypass. RESULTS: Some conventional procedures over the gastrointestinal tract have an important effect on T2DM control, without a direct effect of weight loss. Some studies report that rearranging the gastrointestinal tract anatomy is the key factor that lead to that beneficial metabolic effect of surgery. All bariatric operations lead to T2DM improvement, but with distinct mechanisms underlying that effect. CONCLUSION: There is a trend to stimulate research in this new exciting field. Randomized controlled trials are demanded, comparing surgical versus the best medical treatment of T2DM. After those results, the exact role of gastrointestinal tract surgery will be defined and its benefit over medical treatment as well.
Bariatric surgery; Obesity, morbid; Diabetes mellitus; Gastric bypass
