¿Es la diabetes mellitus tipo 2 una enfermedad de tratamiento quirúrgico?
Palabras clave:
diabetes mellitus tipo 2, obesidad, cirugía bariátrica, ghrelinaResumen
Uno de los hallazgos más sorprendentes de la cirugía bariátrica es la resolución de la mayoría de las enfermedades asociadas a la obesidad, especialmente la diabetes mellitus tipo 2: se encuentran tasas de remisión completas de 84% a 98,9% de los pacientes.
Los hallazgos muestran que la remisión de la diabetes mellitus tipo 2 no puede ser explicada únicamente por los cambios de peso experimentados por los pacientes. Hay diversas teorías para la explicación de la normalización de la glucemia, como una mayor producción de incretinas (glucagon-like peptide 1, GLP-1) por parte del intestino distal, fenómenos relacionados con la exclusión del paso de nutrientes por el duodeno, hormonas como la ghrelina y otros efectos que no se han descrito.
Un campo de intensa investigación actual es el uso de procedimientos quirúrgicos para el control de la diabetes mellitus tipo 2 en los pacientes no obesos.
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Referencias bibliográficas
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https://doi.org/10.1093/oxfordjournals.aje.a009187
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https://doi.org/10.1097/00000658-199509000-00011
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https://doi.org/10.1001/jama.299.3.316
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https://doi.org/10.1007/s00125-004-1379-6
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https://doi.org/10.1210/en.2003-0323
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https://doi.org/10.1016/j.cmet.2006.10.001
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https://doi.org/10.1074/jbc.M500540200
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https://doi.org/10.2337/diabetes.50.3.609
27. NAUCK MA., HEIMESAAT MM., ORSKOV C., HOLST JJ., EBERT R., CREUTZFELDT W. Preserved incretin activity of glucagon-like peptide 1 [7-36 amide] but not of synthetic human gastric inhibitory polypeptide in patients with type-2 diabetes mellitus. J Clin Invest. 1993; 91:301-7.
https://doi.org/10.1172/JCI116186
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https://doi.org/10.2337/dc06-1136
2. ASCHNER P., KING H., TRIANA M., RODRÍGUEZ BM. Glucose intolerance in Colombia. A population-based survey in an urban community. Diabetes Care. 1993; 16:90-3.
https://doi.org/10.2337/diacare.16.1.90
3. LEIBSON CL., O ́BRIEN PC., ATKINSON E., PALUMBO PJ., MELTON LJ. Relative contributions of incidence and survival to increasing prevalence of adult-onset diabetes mellitus: A population based study. Am J Epidemiol. 1997; 146: 12-22.
https://doi.org/10.1093/oxfordjournals.aje.a009187
4. Center for Control Disease Morbidity and mortality Weekly Report. 2004; 53:1066-8.
5. BUCHWALD H., AVIDOR Y., BRAUNWALD E., JENSEN MD., PORIES W., FAHRBACH K., SCHOELLES, K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724-37
https://doi.org/10.1001/jama.292.14.1724
6. PORIES WJ., SWANSON MS., MACDONALD KG., LONG SB., MORRIS PG., BROWN BM. et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg. 1995; 222:339-52.
https://doi.org/10.1097/00000658-199509000-00011
7. DIXON JB., O ́BRIEN PE., PLAYFAIR J., CHAPMAN L., SCHACHTER LM., SKINNER S., et al. Adjustable gastric banding and conventional therapy for type 2 diabetes. JAMA. 2008; 299:316-23.
https://doi.org/10.1001/jama.299.3.316
8. American Diabetes Association. Prevention or delay of type 2 diabetes. Diabetes Care. 2004;27(Suppl.1):s47-53.
https://doi.org/10.2337/diacare.27.2007.S47
9. PATIÑO JF. Cirugía Bariátrica. Rev Colomb Cir. 2003;18:28-50.
10. BAYLISS WM., STARLING EH. On the causation of the so-called "peripheral reflex secretion" of the pancreas. Proc R Soc Lond Biol. 1902;69:352-3.
https://doi.org/10.1098/rspl.1901.0119
11. LA BARRE J. Sur les possibilities d'un traitement du diabete par l'incretine. Bull Acad R Med Belg. 1932;12:620-34.
12. MCINTYRE N., HOLSWORTH DC., TURNER DS. New Interpretation of oral glucose tolerance. Lancet. 1964; 2:20-1.
https://doi.org/10.1016/S0140-6736(64)90011-X
13. ELRICK H., STIMMLER L., HLAD CJ. JR., ARAI Y. Plasma insulin response to oral and intravenous glucose administration. J Clin Invest. 1964;24: 1076-82.
https://doi.org/10.1210/jcem-24-10-1076
14. MOJSOV S., WEIR GC., HABENER JF. Insulinotropin: glucagon-like peptide I (7-37) co-encoded in the glucagon gene is a potent stimulator of insulin release in the perfused rat pancreas. J Clin Invest. 1987;79:616-9.
https://doi.org/10.1172/JCI112855
15. KREYMANN B., WILLIAMS G., CHATEI MA., BLOOM SR. Glucagon- like peptide 1 7-36: a physiological incretin in man. Lancet.1987; 2:1300-4.
https://doi.org/10.1016/S0140-6736(87)91194-9
16. HELLER RS., STOFFERS DA., LIU A., SCHEDL A., CRENSHAW EB. 3RD, MADSEN OD., et al. The role of BM4/Pou3f4 and Pax6 in forming the pancreatic glucagon cell identity. Dev Biol. 2004; 268:123-34.
https://doi.org/10.1016/j.ydbio.2003.12.008
17. HOLZ GG., KUHTREIBER WM., HABENER JF. Pancreatic beta-cells are rendered glucose-competent by the insulinotropic hormone glucagon- like peptide-1 (7-37). Nature. 1993; 361:362-5.
https://doi.org/10.1038/361362a0
18. BUTEAU J., EL-ASSAD W., RHODES CJ., ROSEMBERG L., JOLY E., PRENTKI M. Glucagon-like peptide-1 prevents beta cell glucolipotoxicity. Diabetologia. 2004;47:806-15.
https://doi.org/10.1007/s00125-004-1379-6
19. FARILLA L., BULOTTA A., HIRSHBERG B., LI CALZI S., KHOURY N., NOUSHMEHR H., et al. GLP-1 inhibits cell apoptosis and improves glucose responsiveness of freshly isolated human islets. Endocrinology. 2003;144:5149-58.
https://doi.org/10.1210/en.2003-0323
20. YUSTA B., BAGGIO LL., ESTALL JL., KOEHLER JA., HOLLAND DP., LI H., et al. GLP-1 receptor activation improves beta cell function and survival following induction of endoplasmic reticulum stress. Cell Metab. 2006; 4:391-406.
https://doi.org/10.1016/j.cmet.2006.10.001
21. WILLMS B., WERNER J., HOLST JJ., ORSKOV C., CREUTZFELD W., NAUCK MA. Gastric emptying, glucose responses and insulin secretion after a liquid test meal: effects of exogenous glucagon- like peptide-1 (GLP-1) amide in type 2 (noninsulin-dependent) diabetic patients. J Clin Endocrinol Metab. 1996; 81:327-32.
https://doi.org/10.1210/jcem.81.1.8550773
22. MEIER JJ., GALLWITZ B., SALMEN S., GOETZE O., HOLST JJ., SCHMIDT WE., et al. Normalization of glucose concentrations and deceleration of gastric emptying after solid meals during intravenous glucagon-like peptide 1 in patients with type 2 diabetes. J Clin Endocrinol Metab. 2003;88: 2719-25.
https://doi.org/10.1210/jc.2003-030049
23. TSENG CC., KIEFFER TJ., JARBOE LA., USDIN TB., WOLFE MM. Postprandial stimulation of insulin release by glucose-dependent insulinotropic polypeptide (GLP). Effect of a specific glucose- dependent insulinotropic polypeptide receptor antagonist in the rat. J Clin Invest. 1996; 98:2440-5.
https://doi.org/10.1172/JCI119060
24. MIYAWAKI K., YAMADA Y., YANO H., NIWA H., BAN N., IHARA Y., et al. Glucose intolerance caused by a defect in the entero-insular axis: a study in gastric inhibitory polypeptide receptor knockout mice. Proc Natl Acad Sci USA. 1999; 96:14843-7.
https://doi.org/10.1073/pnas.96.26.14843
25. KIM SJ., WINTER K., NIAN C., TSUNEOKA M., KODA Y., MCINTOSH CH. GIP stimulation of pancreatic beta-cell survival is dependent upon phosphatidylinositol 3-kinase (PI3-K)/protein kinase B (PKB) signaling, inactivation of the forkhead transcription factor Foxo1 and down regulation of bax expression. J Biol Chem. 2005; 280:22297-307.
https://doi.org/10.1074/jbc.M500540200
26. VILSBOLL T., KRARUP T., DEACON CF., MADSBAD S., HOLST JJ. Reduced postprandial concentrations of intact biologically active glucagon-like peptide 1 in type 2 diabetic patients. Diabetes. 2001; 50:609-13.
https://doi.org/10.2337/diabetes.50.3.609
27. NAUCK MA., HEIMESAAT MM., ORSKOV C., HOLST JJ., EBERT R., CREUTZFELDT W. Preserved incretin activity of glucagon-like peptide 1 [7-36 amide] but not of synthetic human gastric inhibitory polypeptide in patients with type-2 diabetes mellitus. J Clin Invest. 1993; 91:301-7.
https://doi.org/10.1172/JCI116186
28. TODD JF., EDWARDS CM., GHATEI MA., MATHER HM., BLOOM SR. Subcutaneous glucagon-like peptide-1 improves postprandial glycaemic control over a 3-week period in patients with early type 2 diabetes. Clin Sci (Lond) 1998;95:325 -9
https://doi.org/10.1042/cs0950325
29. YOUNG AA., GEDULIN BR., BHAVSAR S., BODKIN N., JODKA C., HANSEN B., et al. Glucose-lowering and insulin-sensitizing actions of exendin-4: studies in obese diabetic (ob/ob,db/db) mice, diabetic fatty Zucker rats, and diabetic rhesus monkeys (Macaca mulatta). Diabetes. 1999; 48:1026-34.
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2010-01-01
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Rosero, G. ¿Es La Diabetes Mellitus Tipo 2 Una Enfermedad De Tratamiento quirúrgico?. Rev Colomb Cir 2010, 25, 27-36.
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