Type 2 Diabetes Mellitus (or T2DM, or adult-onset diabetes) may serve as an excellent example of metabolic, obesity-related comorbidity which can be treated with bariatric-metabolic procedure even without direct relation to weight loss! Even non-obese or thin patients with poorly controlled diabetes are ideal candidates to benefit enormously from Metabolic Surgery.
In such cases bariatric surgery evolves into metabolic surgery. Thus metabolic operations (due to malabsorption of food) in the obese patients, deeply influence hormonal secretion especially in the proximal part of small bowel, and have positive influence on insulin secretion, sensitivity and on the entire complex of glucose tolerance.
Nowadays we can witness dramatic changes in perception of T2DM from bariatric surgeons, diabetologists, and many other medical specialists. T2DM has evolved from primarily medical disease into a condition where surgeons may play a more active role in the management of the diabetic patient.
However, it has to be stressed that metabolic treatment of T2DM and other metabolic disorders need multidisciplinary approach and collaboration and that the surgeon should play a very important role as a multidisciplinary team member.