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Shifting the Journal submission-review system to the Editorial System Manuscript December 27, 2017.
REVIEW ARTICLE
Metabolic surgery in patients with diabesity: A review of the historical backgrounds and scoring systems
1
Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
2
Department of Physiology, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, SAUDI ARABIA
Publication date: 2024-01-03
Electron J Gen Med 2024;21(1):em564
KEYWORDS
ABSTRACT
Diabesity is a modern term that describes the coexistence of adverse health effects of diabetes mellitus and
obesity and indicates a causal pathophysiological relationship between the two phenomena. The progression of
diabesity leads to a deterioration of multiple organs and systems. Effective intervention for patients with diabesity
must include optimal obesity therapy to prevent secondary complications. Metabolic surgery is the most effective
and sustainable therapy for severe obesity and the elimination or prevention of many associated diseases,
including type 2 diabetes mellitus, hypertension, sleep apnea, heart disease, and certain cancers. This review
provides an up-to-date overview of surgical interventions for obesity, particularly the development of metabolic
surgery. It evaluates different scoring systems for evidence-based selection of metabolic surgery based on disease
severity. We reviewed different predictive scoring systems for better evidence-based selection of the best
metabolic surgery for patients with diabesity. We found that medication type, fasting insulin level, and C-peptide
influence the outcomes of different types of metabolic surgery and heterogeneous remission rates. There are
different predictive scoring systems for evidence-based selection of the best metabolic surgery, either sleeve or
mini-bypass, that will ensure the highest chance of diabetes remission. Using the metabolic score calculator is a
useful tool to help medical specialists determine the optimal treatment strategy for a particular patient. More
research is needed before we can agree on the ideal bariatric procedure that offers the highest chance of remission
with the lowest incidence of hypoglycemia.
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