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Adipositas - Ursachen, Folgeerkrankungen, Therapie 2012; 06(02): 93-98
DOI: 10.1055/s-0037-1618777
Übersichtsarbeit
Schattauer GmbH

Metabolische Chirurgie – für alle übergewichtigen und adipösen Diabetiker?

Metabolic surgery – for all diabetes patients?
A. Wirth
1   Bad Rothenfelde
› Author Affiliations
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Publication History

Publication Date:
29 December 2017 (online)

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Zusammenfassung

Die Adipositas ist hauptverantwortlich für die zunehmende Häufigkeit des Typ-2-Diabetes mellitus (T2DM). Da adipöse Diabetiker durch Maßnahmen zur Lebensstiländerung in der Regel das Zielgewicht nicht erreichen, sind in manchen Fällen chirurgische Eingriffe als ulti- ma ratio zu erwägen.

Chirurgische Interventionen bei adipösen Dia- betikern (metabolische Chirurgie) sind hin- sichtlich der Reduktion des Körperfetts und von kardiovaskulären Risikofaktoren effektiv, ¾ aller Patienten mit T2DM kommen in eine Remission. Unklar ist die Indikation für eine metabolische Chirurgie hinsichtlich Fettverteilung, Dauer und Schweregrad des T2DM, Beta-Zell Funktion, mikrovaskulären Kompli- kationen und operativem Vorgehen. Kompli- kationen sind moderat, Hypoglykämien treten bei manchen Verfahren gehäuft auf. Die Qualität des Operationsteams sollte sich an Standards ausrichten und die Nachsorge sollte ge- nerell und umfassend geregelt sein.

Summary

Obesity is the main determinant for the in- creasing prevalence of type 2 diabetes mellitus (T2DM). Since most diabetic patients do not reach therapeutic goals by changes in life-style, surgical interventions should be considered as a therapeutic option of last resort. Operations for obese diabetic patients (metabolic surgery) are effective with respect to reductions in body fat and cardiovascular risk factors and ¾ of all patients achieve re- mission. However, the indication for metabolic surgery is less clear concerning body fat distribution, duration and severity of the T2DM, beta-cell function, microvascular complications and the surgical procedure of choice remains controversial . Complications are moderate, but hypoglycaemic events occur frequently. The quality of the surgical team should be in line with standards and the post-operative care should be controlled generally and comprehensively.

Schlüsselwörter

Metabolische Chirurgie - Adipositas - Diabetes

Keywords

Metabolic surgery - Obesity - Diabetes
 

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