Bariatrische Operationen bei Adipositas und Typ-2-Diabetes – Typ-2-Diabetiker profitieren überproportional

Zusammenfassung

Die Zunahme von Adipositas und ihrer Folgeerkrankungen, insbesondere Typ-2-Diabetes, erfordert die Intensivierung aller bekannten präventiven und therapeutischen Maßnahmen. Hierzu zählen bei Adipositas Grad 3 neben den konservativen Programmen gegebenenfalls auch adipositaschirurgische (bariatrische) Operationen. Typ-2-Diabetiker profitieren überproportional, da sich unmittelbar nach insbesondere malabsorptiven Operationsverfahren die Stoffwechsellage dramatisch bessert, und zwar unabhängig von der erst im Laufe von Wochen und Monaten beobachteten Gewichtsabnahme. Langzeitstudien mit bis zu 15 Jahren Follow-up belegen den nachhaltigen positiven Effekt bariatrischer Operationen auf Gewichtsverlust, adipositasassoziierte Erkrankungen und Mortalität. Die Arbeitsgruppe Adipositas des BDEM (Bundesverband Deutscher Ernährungsmediziner e. V.) hat einen Behandlungspfad zur Therapie von Personen mit massiver Adipositas entwickelt.

Increasing adiposity and its subsequent diseases, especially Type 2 diabetes, makes it necessary to intensify all the well-known preventive and therapeutic measures. These include, in case of grade 3 adiposity, not only the conservative programmes but also whenever necessary bariatric surgery (adipose patient surgery). This will super-proportionally benefit Type 2 diabetics, since there is an immediate dramatic improvement in the metabolic condition of the patients especially subsequent to malabsorption surgery, independent of the weight loss. The persistently positive effect of bariatric surgery has been established with regard to weight loss, adiposity-associated diseases and mortality, by means of long-term studies with a follow-up of up to 15 years. A guideline for the treatment of highly adipose patients has been compiled by the Federal German Association of Physicians Engaged in Nutritional Medicine.

Key words

Diabetes mellitus - massive adiposity - bariatric surgery

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