Article1 min read·Published Sep 2010Older

Morbid obesity in pediatric diabetes mellitus: surgical options and outcomes

Part of Adolescent Bariatric Surgery 39 items

pubmed.ncbi.nlm.nih.gov

Michael Helmrath

The current obesity epidemic has led to a dramatic increase in insulin resistance and type 2 diabetes mellitus among adolescents, along with other obesity-related comorbidities, such as hypertension, hyperlipidemia, obstructive sleep apnea, psychosocial impairment and nonalcoholic fatty liver disease. Medical treatment of severe obesity is effective in only a small percentage of adolescent patients. In light of the potentially life-threatening complications of obesity, bariatric surgery can be considered a treatment option for adolescent patients with morbid obesity. Indications for surgery rely on both BMI and comorbidity criteria, as well as the ability of the adolescents and their family to understand and comply with perioperative protocols. The long-term effects of bariatric surgery in adolescents are not known; therefore, participation in prospective outcome studies is important. The risk associated with bariatric surgery in adolescents seems to be similar to that observed in adult patients in the short term. Data suggest that bypass procedures successfully reverse or improve abnormal glucose metabolism in the majority of patients and may be more effective in adolescents than adults. This improvement in glucose metabolism occurs before marked weight loss in patients undergoing bypass procedures, suggesting a direct effect on the hormonal control of glucose metabolism.

pubmed.ncbi.nlm.nih.gov shows its articles on its own site.

Read the article on pubmed.ncbi.nlm.nih.gov ↗

Article · Sep 2010 · 1 min read

In brief

This article examines bariatric surgery as a treatment option for adolescents with morbid obesity and type 2 diabetes, reviewing patient selection criteria, surgical outcomes, and metabolic effects. Bypass procedures demonstrate rapid improvement in glucose metabolism independent of weight loss, with short-term safety profiles comparable to adult populations.

Written by the GCMD Library team from the article.

Michael Helmrath

Statements in this article

The obesity epidemic has led to a dramatic increase in insulin resistance and type 2 diabetes mellitus among adolescents.
Established
Obesity-related comorbidities in adolescents include hypertension, hyperlipidemia, obstructive sleep apnea, psychosocial impairment and nonalcoholic fatty liver disease.
Established
Medical treatment of severe obesity is effective in only a small percentage of adolescent patients.
Established
Bariatric surgery can be considered a treatment option for adolescent patients with morbid obesity in light of potentially life-threatening complications.
Recommendation
Indications for bariatric surgery rely on both BMI and comorbidity criteria.
Guideline
Adolescents and their family must have the ability to understand and comply with perioperative protocols before bariatric surgery.
Recommendation
The long-term effects of bariatric surgery in adolescents are not known.
Open
Participation in prospective outcome studies is important for adolescents undergoing bariatric surgery.
Recommendation
The risk associated with bariatric surgery in adolescents seems to be similar to that observed in adult patients in the short term.
Research
Bypass procedures successfully reverse or improve abnormal glucose metabolism in the majority of patients.
Research
Bariatric bypass procedures may be more effective in adolescents than adults for improving glucose metabolism.
Research
Improvement in glucose metabolism occurs before marked weight loss in patients undergoing bypass procedures, suggesting a direct effect on hormonal control of glucose metabolism.
Research