Bariatric surgery leads to marked and long-lasting weight reduction .
A large proportion of patients undergoing bariatric surgery have DM2 .
Glycemic control improves in the months after laparoscopic adjustable gastric b and ing , but it improves more rapidly and completely after laparoscopic Roux-en-Y gastric bypass surgery .
Thus , both types of surgery are capable of improving or even curing DM2 , but the mechanisms may differ
OBJECTIVE To systematic ally review the literature pertaining to the reversal of  type 2 diabetes mellitus ( DM2 ) after Roux-en-Y gastric bypass and adjustable gastric b and ing .
Loss of 50% of excess weight using a very low energy diet improves insulin-stimulated glucose disposal and skeletal muscle insulin signalling in obese insulin-treated type 2 diabetic patients
Aims /hypothesisBoth energy restriction ( ER ) per se and weight loss improve glucose metabolism in obese insulin-treated type 2 diabetic patients . Short-term ER decreases basal endogenous glucose production ( EGP ) but not glucose disposal . In contrast the blood glucose-lowering mechanism of long-term ER with substantial weight loss has not been fully eluci date d. The aim of this study was to investigate the effect of loss of 50 % of excess weight [ 50 % excess weight reduction ( EWR ) ] on EGP , whole-body insulin sensitivity and the disturbed myocellular insulin-signalling pathway in ten obese insulin-treated type 2 diabetic patients . Methods A euglycaemic – hyperinsulinaemic clamp with stable isotopes ( [6,6 - 2H2]glucose and [2H5]glycerol ) combined with skeletal muscle biopsies was performed during a very low energy diet ( VLED ; 1,883 kJ/day ) on day 2 and again after 50 % EWR . Oral blood glucose-lowering agents and insulin were discontinued 3 weeks prior to the VLED and at the start of the VLED , respectively . Results Loss of 50 % EWR ( 20.3 ± 2.2 kg from day 2 to day of 50 % EWR ) normalised basal EGP and improved insulin sensitivity , especially insulin-stimulated glucose disposal ( 18.8 ± 2.0 to 39.1 ± 2.8 μmol kg fat-free mass−1 min−1 , p = 0.001 ) . The latter was accompanied by improved insulin signalling at the level of the recently discovered protein kinase B/Akt substrates AS160 and PRAS40 along with a decrease in intramyocellular lipid ( IMCL ) content . Conclusions /interpretationConsiderable weight loss in obese , insulin-treated type 2 diabetic patients normalises basal EGP and improves insulin sensitivity result ing from an improvement in insulin signal transduction in skeletal muscle . The decrease in IMCL might contribute to this effect
Bariatric surgery leads to marked and long-lasting weight reduction .
A large proportion of patients undergoing bariatric surgery have DM2 .
Glycemic control improves in the months after laparoscopic adjustable gastric b and ing , but it improves more rapidly and completely after laparoscopic Roux-en-Y gastric bypass surgery .
Thus , both types of surgery are capable of improving or even curing DM2 , but the mechanisms may differ
OBJECTIVE To systematic ally review the literature pertaining to the reversal of  type 2 diabetes mellitus ( DM2 ) after Roux-en-Y gastric bypass and adjustable gastric b and ing .