XX Conference of the Graduate Committee of the Argentine Diabetes Society Topic: Obesity and diabetes. Table 3: Pharmacological and surgical therapy in obesity and diabetes
DOI:
https://doi.org/10.47196/diab.v59i3Sup.1295Keywords:
diabetes mellitus, obesity, diabesity, anti-obesity drugs, anti-diabetes drugs, bariatric surgery, glycemic control, microvascular complications, macrovascular complicationsAbstract
Significant advances have been made in recent years in both pharmacological and surgical treatment strategies for obesity and diabetes. New therapeutic agents have proven effective in weight reduction, glycemic control, and cardiovascular risk prevention, while innovations in surgical techniques have broadened the spectrum of safe and effective interventions. This review, conducted by graduates of the Argentine Diabetes Society under expert national supervision, aims to update current perspectives on the integrated management of "diabesity." Addressing this dual condition requires a paradigm shift among healthcare providers, emphasizing proactive care, continuous evidence-based decision-making, interdisciplinary collaboration, and a personalized, patient-centered approach.
References
I. World Obesity Day. Obesity and non-communicable disease. Disponible en: https://es.worldobesityday.org/obesity-and-ncds.
II. Instituto Nacional de Estadística y Censo (INDEC). Cuarta Encuesta Nacional de Factores de Riesgo 2018. Disponible en: www.indec.gob.ar/ftp/cuadros/publicaciones/enfr_2018_resultados_definitivos.pdf.
III. 3. International Diabetes Federation. Diabetes Atlas 2025. Disponible en: https://diabetesatlas.org/media/uploads/sites/3/2025/04/IDF_Atlas_11th_Edition_2025-1.pdf.
IV. Lazzaroni E, Ben Nasr M, Loretelli C, et al. Anti-diabetic drugs and weight loss in patients with type 2 diabetes. Pharmacol Res 2021; 171: 105782.
V. Wu P, Wen W, Li J, et al. Systematic review and meta-analysis of randomized controlled trials on the effect of SGLT2 inhibitor on blood Leptin and adiponectin level in patients with type 2 diabetes. Horm Metab Res 2019;51:487-494.
VI. Bolinder J, Ljunggren O, Johansson L, et al. Dapagliflozin maintains glycaemic control while reducing weight and body fat mass over 2 years in patients with type 2 diabetes mellitus inadequately controlled on metformin. Diabetes Obes Metab 2014;16:159-169.
VII. Jahangiri S, Malek M, Kalra S, et al. The effects of sodium-glucose cotransporter 2 inhibitors on body composition in type 2 diabetes mellitus: a narrative review. Diabetes Ther 2023;14:2015-2030.
VIII. Husain M, Birkenfeld AL, Donsmark M, et al. Oral semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2019;381:841-851.
IX. Aroda VR, Aberle J, Bardtrum L, et al. Efficacy and safety of once-daily oral semaglutide 25 mg and 50 mg compared with 14 mg in adults with type 2 diabetes (PIONEER PLUS): a multicentre, randomised, phase 3b trial. Lancet 2023;402:693-704.
X. DeFronzo RA, Buse JB, Kim T, et al. Once-daily delayed-release metformin lowers plasma glucose and enhances fasting and postprandial GLP-1 and PYY: results from two randomised trials. Diabetologia 2016;59:1645-1654.
XI. Phung OJ, Scholle JM, Talwar M, et al. Effect of noninsulin antidiabetic drugs added to metformin therapy on glycemic control, weight gain, and hypoglycemia in type 2 diabetes. JAMA 2010;303:1410-1418.
XII. Ko KD, Kim KK, Lee KR. Does weight gain associated with thiazolidinedione use negatively affect cardiometabolic health? J Obes Metab Syndr 2017;26:102-106.
XIII. Tsapas A, Avgerinos I, Karagiannis T, et al. Comparative effectiveness of glucose-lowering drugs for type 2 diabetes: a systematic review and network meta-analysis. Ann Intern Med 2020;173:278-286.
XIV. Stevens JW, Khunti K, Harvey R, et al. Preventing the progression to Type 2 diabetes mellitus in adults at high risk: A systematic review and network meta-analysis of lifestyle, pharmacological and surgical interventions. Diabetes Res Clin Pract 2015;107:320-331.
XV. Miles JM, Leiter L, Hollander P, et al. Effect of orlistat in overweight and obese patients with type 2 diabetes treated with metformin. Diabetes Care 2002;25:1123-1128.
XVI. Oh TJ. The role of anti-obesity medication in prevention of diabetes and its complications. J Obes Metab Syndr 2019;28:158-166.
XVII. Hollander P, Gupta AK, Plodkowski R, et al. Effects of naltrexone sustained-release/bupropion sustained-release combination therapy on body weight and glycemic parameters in overweight and obese patients with type 2 diabetes. Diabetes Care 2013; 36:4022-4029.
XVIII. Wharton S, Yin P, Burrows M, et al. Extended-release naltrexone/bupropion is safe and effective among subjects with type 2 diabetes already taking incretin agents: a post-hoc analysis of the LIGHT trial. Int J Obes 2021;45:1687-1695.
XIX. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Care in Diabetes-2023. Diabetes Care 2023 Jan 1;46(Suppl 1):S128-39.
XX. Muzurović EM, Volčanšek Š, Tomšić KZ, Janež A, Mikhailidis DP, Rizzo M, et al. Glucagon-like peptide-1 receptor agonists and dual glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1 receptor agonists in the treatment of obesity/metabolic syndrome, prediabetes/diabetes and non-alcoholic fatty liver disease-current evidence. J Cardiovasc Pharmacol Ther 2022 Jan-Dec;27:10742484221146371.
XXI. Popoviciu MS, Păduraru L, Yahya G, Metwally K, Cavalu S. Emerging role of GLP-1 agonists in obesity: a comprehensive review of randomised controlled trials. Int J Mol Sci 2023;24(13). doi: 10.3390/ijms241310449.
XXII. Alruwaili H, Dehestani B, le Roux CW. Clinical impact of liraglutide as a treatment of obesity. Clin Pharmacol 2021 Mar 11;13:53-60.
XXIII. Garvey WT, Birkenfeld AL, Dicker D, Mingrone G, Pedersen SD, Satylganova A, et al. Efficacy and safety of liraglutide 3.0 mg in individuals with overweight or Obesity and type 2 diabetes treated with basal insulin. The SCALE insulin randomized controlled trial. Diabetes Care 2020 May;43(5):1085-93.
XXIV. Jeon E, Lee KY, Kim KK. Approved anti-obesity medications in 2022 KSSO guidelines and the promise of phase 3 clinical trials: anti-obesity drugs in the sky and on the horizon. J Obes Metab Syndr 2023 Jun 30;32(2):106-20.
XXV. Guglielmi V, Bettini S, Sbraccia P, Busetto L, Pellegrini M, Yumuk V, et al. Beyond weight loss: added benefits could guide the choice of anti-obesity medications. Curr Obes Rep 2023 Jun;12(2):127-46.
XXVI. Marso SP, Holst AG, Vilsbøll T. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2017 Mar 2;376(9):891-2.
XXVII. Amaro A, Sugimoto D, Wharton S. Efficacy and safety of semaglutide for weight management: evidence from the STEP program. Postgrad Med 2022 Jan;134(sup1):5-17.
XXVIII. Haddad F, Dokmak G, Bader M, Karaman R. A comprehensive review on weight loss associated with anti-diabetic medications. Life 2023;13(4). doi: 10.3390/life13041012.
XXIX. Kugler AJ, Thiman ML. Efficacy and safety profile of once-weekly dulaglutide in type 2 diabetes: a report on the emerging new data. Diabetes Metab Syndr Obes 2018 May 9;11:187-97.
XXX. Rosenstock J, Wysham C, Frías JP, Kaneko S, Lee CJ, Fernández-Landó L, et al. Efficacy and safety of a novel dual GIP and GLP-1 receptor agonist tirzepatide in patients with type 2 diabetes (SURPASS-1): a double-blind, randomised, phase 3 trial. Lancet 2021 Jul 10;398(10295):143-55.
XXXI. Ludvik B, Giorgino F, Jódar E, Frias JP, Fernández-Landó L, Brown K, et al. Once-weekly tirzepatide versus once-daily insulin degludec as add-on to metformin with or without SGLT2 inhibitors in patients with type 2 diabetes (SURPASS-3): a randomised, open-label, parallel-group, phase 3 trial. Lancet 2021;398(10300):583-98.
XXXII. Sinha R, Papamargaritis D, Sargeant JA, Davies MJ. Efficacy and safety of tirzepatide in type 2 diabetes and obesity management. J Obes Metab Syndr 2023;32(1):25-45.
XXXIII. Forzano I, Varzideh F, Avvisato R, Jankauskas SS, Mone P, Santulli G. Tirzepatide: a systematic update. Int J Mol Sci 2022 Nov 23;23(23). doi: 10.3390/ijms232314631.
XXXIV. Bailey CJ, Flatt PR, Conlon JM. An update on peptide-based therapies for type 2 diabetes and obesity. Peptides 2023 Mar;161:170939.
XXXV. Gao S, Zhang H, Long C, Xing Z. Association between obesity and microvascular diseases in patients with type 2 diabetes mellitus. Front Endocrinol 2021 Oct 26;12:719515.
XXXVI. Shi S, Ni L, Tian Y, Zhang B, Xiao J, Xu W, et al. Association of obesity indices with diabetic kidney disease and diabetic retinopathy in type 2 diabetes: a real-world study. J Diabetes Res 2023 Apr 15;2023:3819830.
XXXVII. Cassuto SBAF. Microvascular responsiveness in obesity: implications for therapeutic intervention. British Journal of Pharmacology 2011 Jul;165:544-60.
XXXVIII. Radojka B, Jagoda B, Snjezana M, Sanja US. The association of obesity and microvascular complications with glycemic control in patients with type 2 diabetes mellitus. Med Arch 2020 Feb;74(1):14-8.
XXXIX. Virdis A, Masi S, Colucci R, Chiriacò M, Uliana M, Puxeddu I, et al. Microvascular endothelial dysfunction in patients with obesity. Curr Hypertens Rep 2019 Apr 4;21(4):32.
XL. Boye KS, Ford JH, Thieu VT, Lage MJ, Terrell KA. The association between obesity and the 5-Year prevalence of morbidity and mortality among adults with type 2 diabetes. Diabetes Ther 2023 Apr;14(4):709-21.
XLI. Tong PCY, Lee ZSK, Sea MM, Chow CC, Ko GTC, Chan WB, et al. The effect of orlistat-induced weight loss, without concomitant hypocaloric diet, on cardiovascular risk factors and insulin sensitivity in young obese Chinese subjects with or without type 2 diabetes. Arch Intern Med 2002 Nov 25;162(21):2428-35.
XLII. Boyd AL, Barlow PM, Pittenger GL, Simmons KF, Vinik AI. Topiramate improves neurovascular function, epidermal nerve fiber morphology, and metabolism in patients with type 2 diabetes mellitus. Diabetes Metab Syndr Obes 2010 Dec 6;3:431-7.
XLIII. Wiffen PJ, Derry S, Lunn MPT, Moore RA. Topiramate for neuropathic pain and fibromyalgia in adults. Cochrane Database Syst Rev 2013 Aug 30;2013(8):CD008314.
XLIV. Marso SP, Daniels GH, Brown-Frandsen K, Kristensen P, Mann JFE, Nauck MA, et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N Engl J Med 2016 Jul 28;375(4):311-22.
XLV. Marso SP, Holst AG, Vilsbøll T. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med 2017 Mar 2;376(9):891-2.
XLVI. Sattar N, Lee MMY, Kristensen SL, Branch KRH, Del Prato S, Khurmi NS, et al. Cardiovascular, mortality, and kidney outcomes with GLP-1 receptor agonists in patients with type 2 diabetes: a systematic review and meta-analysis of randomised trials. Lancet Diabetes Endocrinol 2021 Oct;9(10):653-62.
XLVII. Mali N, Su F, Ge J, Fan WX, Zhang J, Ma J. Efficacy of liraglutide in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials. BMC Endocr Disord 2022 Apr 7;22(1):93.
XLVIII. Goldney J, Sargeant JA, Davies MJ. Incretins and microvascular complications of diabetes: neuropathy, nephropathy, retinopathy and microangiopathy. Diabetologia 2023 Oct;66(10):1832-45.
XLIX. Mann J, Orsted D, Brown Frandsen K. Liraglutide and renal outcomes in type 2 diabetes. N Engl J Med 2017 Aug;377:839-48.
L. Davies MJ, Bergenstal R, Bode B, Kushner RF, Lewin A, Skjøth TV, et al. Efficacy of liraglutide for weight loss among patients with type 2 diabetes: the SCALE diabetes randomized clinical trial. JAMA 2015;314(7):687-99.
LI. Mann JFE, Buse JB, Idorn T, Leiter LA, Pratley RE, Rasmussen S, et al. Potential kidney protection with liraglutide and semaglutide: Exploratory mediation analysis. Diabetes Obes Metab 2021 Sep;23(9):2058-66.
LII. Sinha R, Papamargaritis D, Sargeant JA, Davies MJ. Efficacy and safety of tirzepatide in type 2 diabetes and obesity management. J Obes Metab Syndr 2023;32(1):25-45.
LIII. Bethel MA, Diaz R, Castellana N, Bhattacharya I, Gerstein HC, Lakshmanan MC. HbA Change and diabetic retinopathy during GLP-1 receptor agonist cardiovascular outcome trials: a meta-analysis and meta-regression. Diabetes Care 2021 Jan;44(1):290-6.
LIV. Cigrovski Berkovic M, Strollo F. Semaglutide-eye-catching results. World J Diabetes 2023;14(4):424-34.
LV. Vilsbøll T, Bain SC, Leiter LA, Lingvay I, Matthews D, Simó R, et al. Semaglutide, reduction in glycated haemoglobin and the risk of diabetic retinopathy. Diabetes Obes Metab 2018 Apr;20(4):889-97.
LVI. El Mouhayyar C, Riachy R, Khalil AB, Eid A, Azar S. SGLT2 inhibitors, GLP-1 agonists, and DPP-4 inhibitors in diabetes and microvascular complications: a review. Int J Endocrinol 2020 Feb 29;2020:1762164.
LVII. Brajkovich IE, Aschner P, Taboada L, Camperos P, Gómez-Pérez R, Aure G, et al. Consenso ALAD. Tratamiento del paciente con diabetes mellitus tipo 2 y obesidad. ALAD 2019;9(91). Disponible en: http://www.revistaalad.com/frame_esp.php?id=404.
LVIII. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 10. Cardiovascular disease and risk management: Standards of Care in Diabetes 2023. Diabetes Care. 1 de enero de 2023;46(Supp1):S158-90.
LIX. Crawford AR, Alamuddin N, Amaro A. Cardiometabolic effects of anti-obesity pharmacotherapy. Curr Atheroscler Rep 2018;20(4):18.
LX. Abdul-Wahab R, le Roux CW. A review of the evidence on cardiovascular outcomes from obesity treatment. Obes Pillars 2023;7:100071.
LXI. Tak YJ, Lee SY. Long-term efficacy and safety of anti-obesity treatment. Where do we stand? Curr Obes Rep 2021;10(1):14-30.
LXII. Holman RR, Bethel MA, Mentz RJ, Thompson VP, Lokhnygina Y, Buse JB, et al. Effects of once-weekly exenatide on cardiovascular outcomes in type 2 diabetes. N Engl J Med 2017;377(13):1228-39.
LXIII. Verma S, Poulter NR, Bhatt DL, Bain SC, Buse JB, Leiter LA, et al. Effects of liraglutide on cardiovascular outcomes in patients with type 2 diabetes mellitus with or without history of myocardial infarction or stroke. Circulation 2018;138(25):2884-94.
LXIV. Pi-Sunyer X, Astrup A, Fujioka K, Greenway F, Halpern A, Krempf M, et al. A randomized, controlled trial of 3.0 mg of liraglutide in weight management. N Engl J Med 2015;373(1):11-22.
LXV. Gerstein HC, Colhoun HM, Dagenais GR, Diaz R, Lakshmanan M, Pais P, et al. Dulaglutide and cardiovascular outcomes in type 2 diabetes (REWIND): a double-blind, randomised placebo-controlled trial. Lancet 2019;394(10193):121-30.
LXVI. Davies M, Færch L, Jeppesen OJ, Pakseresht A. Semaglutide 2.4 mg once a week in adults with overweight or obesity, and type 2 diabetes (STEP 2): a randomised, double-blind, double-dummy, placebo-controlled. Lancet 2021;397:971-84.
LXVII. Lingvay I, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide for cardiovascular event reduction in people with overweight or obesity: SELECT study baseline characteristics. Obesity 2023;31(1):111-22.
LXVIII. Sattar N, Mcguire D, Pavo I. Tirzepatide cardiovascular event risk assessment: a pre-specified meta-analysis. Nature Medicine 2022;28:591-8.
LXIX. Jastreboff AM, Aronne LJ, Ahmad NN, Wharton S, Connery L, Alves B, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med 2022;387(3):205-16.
LXX. Xua L, Otaa T. Emerging roles of SGLT2 inhibitors in obesity and insulin resistance:Focus on fat browning and macrophage polarization Adipocyte 2018;7:121-8.
LXXI. Kluger A, Barbin C. Cardiorenal outcomes in the CANVAS, DECLARE-TIMI 58, and EMPA-REG OUTCOME trials: a systematic review. Rev Cardiovasc Med 2018;19(2):41-9.
LXXII. Vilarrasa N, San Jose P, Rubio MÁ, Lecube A. Obesity in patients with type 1 diabetes: links, risks and management challenges. Diabetes Metab Syndr Obes 2021 Jun 21;14:2807-27.
LXXIII. Casu A, Bilal A, Pratley RE. Advancing care for type 1 diabetes, obesity network (ACT1ON). Pharmacological therapies to address obesity in type 1 diabetes. Curr Opin Endocrinol Diabetes Obes 2020 Aug;27(4):194-206.
LXXIV. Ciężki S, Kurpiewska E, Bossowski A, Głowińska-Olszewska B. Multi-faceted influence of obesity on type 1 diabetes in children. From disease pathogenesis to complications. Front Endocrinol 2022 Jun 16;13:890833.
LXXV. Bush MA. Intensive diabetes therapy and body weight: focus on insulin detemir. Endocrinol Metab Clin North Am 2007 Aug;36 Suppl 1:33-44.
LXXVI. Mottalib A, Kasetty M, Mar JY, Elseaidy T, Ashrafzadeh S, Hamdy O. Weight management in patients with type 1 diabetes and obesity. Curr Diab Rep 2017 Aug 23;17(10):92.
LXXVII. Libman IM, Miller KM, DiMeglio LA, Bethin KE, Katz ML, Shah A, et al. Effect of metformin added to insulin on glycemic control among overweight/obese adolescents with type 1 diabetes: a randomized clinical Trial. JAMA. 2015 Dec 1;314(21):2241-50.
LXXVIII. Yerevanian A, Soukas AA. Metformin: mechanisms in human obesity and weight loss. Curr Obes Rep 2019 Jun;8(2):156-64.
LXXIX. Petrie JR, Chaturvedi N, Ford I, Brouwers MCGJ, Greenlaw N, Tillin T, et al. Cardiovascular and metabolic effects of metformin in patients with type 1 diabetes (REMOVAL): a double-blind, randomised, placebo-controlled trial. Lancet Diabetes Endocrinol 2017 Aug;5(8):597-609.
LXXX. Lane K, Freeby M. Adjunctive therapies in type 1 diabetes mellitus. Curr Opin Endocrinol Diabetes Obes 2021 Feb 1;28(1):8-13.
LXXXI. Qiao YC, Ling W, Pan YH, Chen YL, Zhou D, Huang YM, et al. Efficacy and safety of pramlintide injection adjunct to insulin therapy in patients with type 1 diabetes mellitus: a systematic review and meta-analysis. Oncotarget. 2017;8(39):66504-15.
LXXXII. Janzen KM, Steuber TD, Nisly SA. GLP-1 agonists in type 1 diabetes mellitus. Ann Pharmacother 2016 Aug;50(8):656-65.
LXXXIII. Johansen NJ, Dejgaard TF, et al. Efficacy and safety of meal-time administration of short-acting exenatide for glycaemic control in type 1 diabetes (MAG1C): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol 2020. Doi: 10.1016/S2213-8587(20)30030-9
LXXXIV. Mathieu C, Zinman B, Hemmingsson JU, Woo V, Colman P, Christiansen E, et al. Efficacy and safety of liraglutide added to insulin treatment in type 1 diabetes: the ADJUNCT ONE treat-to-target randomized trial. Diabetes Care 2016 Oct;39(10):1702-10.
LXXXV. Dejgaard TF, von Scholten BJ, Christiansen E, Kreiner FF, Bardtrum L, von Herrath M, et al. Efficacy and safety of liraglutide in type 1 diabetes by baseline characteristics in the ADJUNCT ONE and ADJUNCT TWO randomized controlled trials. Diabetes Obes Metab. 2021 Dec;23(12):2752-62.
LXXXVI. Dejgaard TF, Frandsen CS, Hansen TS, Almdal T, Urhammer S, Pedersen-Bjergaard U, et al. Efficacy and safety of liraglutide for overweight adult patients with type 1 diabetes and insufficient glycaemic control (Lira-1): a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol 2016 Mar;4(3):221-32.
LXXXVII. Mertens J, de Winter HT, Mazlom H, Peiffer FW, Dirinick EL, Bochanen N, et al. Effect of once-weekly semaglutide on weight change and metabolic control in people with type 1 diabetes-Six-months results from the real-world STEMT trial. Diabetes 2022 Jun 1;(Supp_1):751.
LXXXVIII. Araki E, Mathieu C, Shiraiwa T, Maeda H, Ikeda H, Thoren F, et al. Long-term (52-week) efficacy and safety of dapagliflozin as an adjunct to insulin therapy in Japanese patients with type 1 diabetes: subgroup analysis of the DEPICT-2 study. Diabetes Obes Metab 2021 Jul;23(7):1496-504.
LXXXIX. Rosenstock J, Marquard J, Laffel LM, Neubacher D, Kaspers S, Cherney DZ, et al. Empagliflozin as adjunctive to insulin therapy in type 1 diabetes: The EASE Trials. Diabetes Care 2018 Dec;41(12):2560-9.
XC. Garg SK, Strumph P. Effects of sotagliflozin added to insulin in type 1 diabetes. N Engl J Med 2018 Mar 8;378(10):967-8.
XCI. Maric-Bilkan C. Obesity and diabetic kidney disease. Med Clin North Am 2013 Jan;97(1):59-74.
XCII. Chintam K, Chang AR. Strategies to treat obesity in patients with CKD. Am J Kidney Dis. 2021 Mar;77(3):427-39.
XCIII. Abdul-Wahab R, Cohen RV, le Roux CW. Recent advances in the treatment of patients with obesity and chronic kidney disease. Ann Med 2023 Dec;55(1):2203517.
XCIV. Pedersen SD, Manjoo P, Wharton S. Canadian adult obesity clinical practice guidelines: Pharmacotherapy for Obesity Management 2022. Disponible en: https://obesitycanada.ca/guidelines/pharmacotherapy.
XCV. Comité Nacional de Nutrición. Obesity: guidelines for clinical management. Executive summary. Arch Argent Pediatr. 2016 Apr;114(2):180-1.
XCVI. Hampl SE, Hassink SG, Skinner AC, Armstrong SC, Barlow SE, Bolling CF, et al. Executive summary: clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics 2023 Feb 1;151(2). Disponible: 10.1542/peds.2022-060641
XCVII. Hannon TS, Arslanian SA. Obesity in adolescents. N Engl J Med 2023 Jul 20;389(3):251-61.
XCVIII. Kovalskys I, Mayer M, Armeno M, et al. Consenso intersocietario para el tratamiento de la obesidad en adolescentes en Argentina. Actualización en Nutrición 2022 2022;23(1):103-10.
XCIX. Rovira MG, et al. Recomendaciones para el manejo de las pacientes con diabetes pregestacional. Rev Soc Arg Diab 2017;51(4):153-74.
C. Piccinini-Vallis H, Adamo K, Bell R, Pereira L, Nerenberg K. Canadian Adult Obesity Clinical practice Guidelines. Weight management over the reproductive years for adult women living with obesity. Obesity Canada 2020. Disponible en: https://obesitycanada.ca/guidelines/reproductive.
CI. Sinclair AJ, Pennells D, Abdelhafiz AH. Hypoglycaemic therapy in frail older people with type 2 diabetes mellitus-a choice determined by metabolic phenotype. Aging Clin Exp Res 2022 Sep;34(9):1949-67.
CII. González CD, Di Girolamo G. How do you treat obesity in the elderly pharmacologically? Expert Opin Pharmacother 2021 Sep;22(13):1639-42.
CIII. Courcoulas AP, Gallagher JW, Neiberg RH, Eagleton EB, DeLany JP, Lang W, et al. Bariatric surgery vs. lifestyle intervention for diabetes treatment: 5-year outcomes from a randomized trial. J Clin Endocrinol Metab 2020 Mar 1;105(3):866-76.
CIV. Harraca JL, Grigaites AL, Duartez PM, Ackermann MA, Quevedo P, Musso C, et al. Consenso Argentino Intersociedades de Cirugía Bariátrica y Metabólica. Rev Argent Cir 2021 Apr 8;113(Supp 1):1-70.
CV. Samson SL, Vellanki P, Blonde L, Christofides EA, Galindo RJ, Hirsch IB, et al. American Association of Clinical Endocrinology consensus statement. Comprehensive type 2 diabetes management algorithm 2023 update. Endocr Pract 2023 May 1;29(5):305-40.
CVI. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. 8. Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Care in Diabetes-2023. Diabetes Care 2023 Jan 1;46(Suppl 1):S128-39.
CVII. Pedersen SD. How to apply the Canadian Obesity Clinical Practice Guidelines to people with type 2 diabetes. Can Diabetes Endocrinol Today 2023 Mar 20;5-10.
CVIII. Park CH, Nam SJ, Choi HS, Kim KO, Kim DH, Kim JW, et al. Comparative efficacy of bariatric surgery in the treatment of morbid obesity and diabetes mellitus: a systematic review and network meta-analysis. Obes Surg 2019 Jul;29(7):2180–90.
CIX. Hofsø D, Fatima F, Borgeraas H, Birkeland KI, Gulseth HL, Hertel JK, Johnson LK, Lindberg M, Nordstrand N, Cvancarova Småstuen M, Stefanovski D, Svanevik M, Gretland Valderhaug T, Sandbu R, Hjelmesæth J. Gastric bypass versus sleeve gastrectomy in patients with type 2 diabetes (Oseberg): a single-centre, triple-blind, randomised controlled trial. Lancet Diabetes Endocrinol 2019 Dec;7(12):912-924. doi: 10.1016/S2213-8587(19)30344-4.
CX. Stenberg E, Olbers T, Cao Y, Sundbom M, Jans A, Ottosson J, et al. Factors determining chance of type 2 diabetes remission after Roux-en-Y gastric bypass surgery: a nationwide cohort study in 8057 Swedish patients. BMJ Open Diabetes Res Care 2021 May;9(1). doi: 10.1136/bmjdrc-2020-002033.
CXI. Walter Kunz-Martínez AIPP. Bipartición de tránsito intestinal, la nueva era de la cirugía metabólica para la diabetes mellitus de tipo 2. Revista Colombiana de Cirugía 2018;33(núm. 4):406-20.
CXII. Singh P, Adderley N, Subramanian A, Gokhale K, Singhal R, Toulis KA, et al. The impact of bariatric surgery on incident microvascular complications in patients with type 2 diabetes: a matched controlled population-based retrospective cohort study. Diabetes Care 2021 Jan;44(1):116-24. doi: 10.2337/dc20-0571.
CXIII. Carlsson LMS, Sjöholm K, Karlsson C, Jacobson P, Andersson-Assarsson JC, Svensson PA, et al. Long-term incidence of microvascular disease after bariatric surgery or usual care in patients with obesity, stratified by baseline glycaemic status: a post-hoc analysis of participants from the Swedish Obese Subjects study. Lancet Diabetes Endocrinol 2017 Apr;5(4):271-9.
CXIV. Mingrone G, Panunzi S, De Gaetano A, Guidone C, Iaconelli A, Capristo E, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet 2021 Jan 23;397(10271):293-304.
CXV. Coleman KJ, Haneuse S, Johnson E, Bogart A, Fisher D, O’Connor PJ, et al. Long-term microvascular disease outcomes in patients with type 2 diabetes after bariatric surgery: evidence for the legacy effect of surgery. Diabetes Care 2016 Aug;39(8):1400-7.
CXVI. Heneghan HM, Cetin D, Navaneethan SD, Orzech N, Brethauer SA, Schauer PR. Effects of bariatric surgery on diabetic nephropathy after 5 years of follow-up. Surg Obes Relat Dis 2013 Jan-Feb;9(1):7-14.
CXVII. Chandru S, Pradeepa R, Poonkodi VP, Pramodkumar TA, Kumar MS, Tiwaskar M, et al. Effects of metabolic surgery on diabetic kidney disease and diabetic retinopathy among obese Asian Indians with type 2 diabetes. J Assoc Physicians India 2022 Jan;70(1):11-2.
CXVIII. Sabanayagam C, Wong TY. Diabetic retinopathy and cardiovascular disease. Karger Medical and Scientific Publishers 2019;134.
CXIX. Neff KJ, Le Roux CW. The effect of metabolic surgery on the complications of diabetes. What are the unanswered questions? Front Endocrinol 2020;11.
CXX. Dascalu AM, Stoian AP, Cherecheanu AP, Serban D, Costeado, Tudosie MS, et al. Outcomes of diabetic retinopathy post-bariatric surgery in patients with type 2 diabetes mellitus. J Clin Med Res 2021 Aug 22;10(16). doi: 10.3390/jcm10163736.
CXXI. Kim YJ, Seo DR, Kim MJ, Lee SJ, Hur KY, Choi KS. Clinical course of diabetic retinophaty in Korean type 2 diabetes after bariatric surgery: a pilot study. Retina 2015 May;35(5):935-43.
CXXII. Chen Y, Laybourne JP, Sandinha MT, de Alwis NMW, Avery P, Steel DH, et al. Does bariatric surgery prevent progression of diabetic retinopathy? Eye 2017 Aug;31(8):1131-9.
CXXIII. Aghili R, Malek M, Tanha K, Mottaghi A. The effect of bariatric surgery on peripheral polyneuropathy: a systematic review and meta-analysis. Obes Surg 2019 Sep;29(9):3010-20. doi: 10.1007/s11695-019-04004-1.
CXXIV. Mateo-Gavira I, Vílchez-López FJ, Mayo-Ossorio MÁ, Medina-Rivero D, Sánchez-Toscano E, Pacheco-García JM, et al. Resultados metabólicos de la cirugía bariátrica. Impacto sobre el riesgo cardiovascular. Cir Andal 2019;30(4):510-4.
CXXV. Fisher DP, Johnson E, Haneuse S, Arterburn D, Coleman KJ, O’Connor PJ, et al. Association between bariatric surgery and macrovascular disease outcomes in patients with type 2 diabetes and severe obesity. JAMA 2018 Oct 16;320(15):1570-82.
CXXVI. le Roux CW, Ottosson J, Näslund E, Cohen RV, Stenberg E, Sundbom M, et al. Bariatric surgery: there is a room for improvement to reduce mortality in patients with type 2 diabetes. Obes Surg 2021 Jan;31(1):461-3.
CXXVII. Faucher P, Poitou C, Carette C, Tezenas du Montcel S, Barsamian C, Touati E, et al. Bariatric surgery in obese patients with type 1 diabetes: effects on weight loss and metabolic control. Obes Surg 2016 Feb 17;26(10):2370-8.
CXXVIII. Liu LL, Lawrence JM, et al. Prevalence of overweight and obesity in youth with diabetes in USA: the SEARCH for Diabetes in Youth study. Pediatr Diabetes 2021;11(1):4-11. doi: 10.1111/j.1399-5448.2009.00519.x.
CXXIX. Chillarón JJ, Flores Le-Roux JA, Benaiges D, Pedro-Botet J. Type 1 diabetes, metabolic syndrome and cardiovascular risk. Metabolism Clin Exp 2014 Feb 1;63(2):181-7.
CXXX. Parmar C, Appel S, Lee L, Ribeiro R, Sakran N, Pouwels S. Choice of bariatric surgery in patients with obesity and type 1 diabetes mellitus? an up-to-date systematic review. Obes Surg 2022 Dec;32(12):3992-4006.
CXXXI. Korakas E, Kountouri A, Raptis A, Kokkinos A, Lambadiari V. Bariatric surgery and type 1 diabetes: unanswered questions. Front Endocrinol 2020 Sep 18;11:525909.
CXXXII. Dessify B, Wood C, Parker D, Carmichael D, Petrick A, Daouadi M. Is there a role for bariatric surgery in patients with severe obesity and type 1 diabetes? Surg Obes Relat Dis. 2022 Feb 1;18(2):177-81.
CXXXIII. De Luca M, Angrisani L, Himpens J, Busetto L, Scopinaro N, Weiner R, et al. Indications for surgery for obesity and weight-related diseases: position statements from the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO). Obes Surg 2016 Jul 13;26(8):1659-96.
CXXXIV. Vilarrasa N, San Jose P, Rubio MÁ, Lecube A. Obesity in patients with type 1 diabetes: links, risks and management challenges. Diabetes Metab Syndr Obes 2021 Jun 21;14:2807-27.
CXXXV. Mahawar KK, De Alwis N, Carr WRJ, Jennings N, Schroeder N, Small PK. Bariatric surgery in type 1 diabetes mellitus: a systematic review. Obes Surg 2016 Jan;26(1):196-204.
CXXXVI. Kirwan JP, Aminian A, Kashyap SR, Burguera B, Brethauer SA, Schauer PR. Bariatric surgery in obese patients with type 1 diabetes. Diabetes Care 2016 May 13;39(6):941-8.
CXXXVII. Lannoo M, Dillemans B, Van Nieuwenhove Y, Fieuws S, Mathieu C, Gillard P, et al. Bariatric surgery induces weight loss but does not improve glycemic control in patients with type 1 diabetes. Diabetes Care 2014 Jul 12;37(8):e173-4.
CXXXVIII. Rottenstreich A, Keidar A, Yuval JB, Abu-Gazala M, Khalaileh A, Elazary R. Outcome of bariatric surgery in patients with type 1 diabetes mellitus: our experience and review of the literature. Surg Endosc 2016 Dec;30(12):5428-33.
CXXXIX. Landau Z, Kowen-Sandbank G, Jakubowicz D, Raziel A, Sakran N, Zaslavsky-Paltiel I, et al. Bariatric surgery in patients with type 1 diabetes: special considerations are warranted. Ther Adv Endocrinol Metab 2019 Jan 30;10:2042018818822207.
CXL. Maraka S, Kudva YC, Kellogg TA, Collazo-Clavell ML, Mundi MS. Bariatric surgery and diabetes. Implications of type 1 versus insulin-requiring type 2. Obesity 2015 Mar;23(3):552-7.
CXLI. Aminian A, Kashyap SR, Burguera B, Punchai S, Sharma G, Froylich D, et al. Incidence and clinical features of diabetic ketoacidosis after bariatric and metabolic surgery. Diabetes Care 2016 Apr;39(4):e50-3.
CXLII. Tsujimoto T, Sairenchi T, Iso H, Irie F, Yamagishi K, Watanabe H, et al. The dose-response relationship between body mass index and the risk of incident stage ≥3 chronic kidney disease in a general japanese population: the Ibaraki prefectural health study (IPHS). J Epidemiol. 2014 Jul 5;24(6):444-51.
CXLIII. Heneghan HM, Cetin D, Navaneethan SD, Orzech N, Brethauer SA, Schauer PR. Effects of bariatric surgery on diabetic nephropathy after 5 years of follow-up. Surg Obes Relat Dis 2013 Jan-Feb;9(1):7-14.
CXLIV. Amor A, Jiménez A, Moizé V, Ibarzabal A, Flores L, Lacy AM, et al. Weight loss independently predicts urinary albumin excretion normalization in morbidly obese type 2 diabetic patients undergoing bariatric surgery. Surg Endosc 2013 Jun;27(6):2046-51.
CXLV. Al-Bahri S, Fakhry TK, Gonzalvo JP, Murr MM. Bariatric surgery as a bridge to renal transplantation in patients with end-stage renal disease. Obes Surg 2017 Nov;27(11):2951-5.
CXLVI. Ells LJ, Mead E, Atkinson G, Corpeleijn E, Roberts K, Viner R, et al. Surgery for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev 2015 Jun 24;(6):CD011740.
CXLVII. Pratt JSA, Browne A, Browne NT, Bruzoni M, Cohen M, Desai A, et al. ASMBS pediatric metabolic and bariatric surgery guidelines, 2018. Surg Obes Relat Dis 2018 Jul;14(7):882-901.
CXLVIII. Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis 2022 Dec;18(12):1345-56.
CXLIX. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med 2016 Jan 14;374(2):113-23.
CL. Zhu X, Zhou G, Gu X, Jiang X, Huang H, You S, et al. Comparison of bariatric surgery and medical therapy for obese adolescents with type 2 diabetes. Asian J Surg 2022 Nov 8. doi: 10.1016/j.asjsur.2022.10.079.
CLI. Olbers T, Beamish AJ, Gronowitz E, Flodmark CE, Dahlgren J, Bruze G, et al. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study. Lancet Diabetes Endocrinol 2017 Mar;5(3):174-83.
CLII. Elbahrawy A, Bougie A, Loiselle SE, Demyttenaere S, Court O, Andalib A. Medium to long-term outcomes of bariatric surgery in older adults with super obesity. Surg Obes Relat Dis 2018 Apr;14(4):470-6.
CLIII. Nor Hanipah Z, Punchai S, Karas LA, Szomstein S, Rosenthal RJ, Brethauer SA, et al. The outcome of bariatric surgery in patients aged 75 years and older. Obes Surg 2018 Jun;28(6):1498-503.
CLIV. Smith ME, Bacal D, Bonham AJ, Varban OA, Carlin AM, Ghaferi AA, et al. Perioperative and 1-year outcomes of bariatric surgery in septuagenarians: implications for patient selection. Surg Obes Relat Dis 2019 Oct;15(10):1805-11.
CLV. Carlsson LMS, Peltonen M, Ahlin S, et al. Bariatric surgery and prevention of type 2 diabetes in Swedish obese subjects. N Engl J Med 2012 Aug 23;367(8):695-704. doi: 10.1056/NEJMoa1112082.
CLVI. Booth H, Khan O, Prevost T, et al. Incidence of type 2 diabetes after bariatric surgery: population-based matched cohort study. Lancet Diabetes Endocrinol 2014 Dec;2(12):963-8. doi: 10.1016/S2213-8587(14)70214-1.
CLVII. Lee PC, Tan HC, Pasupathy S et al. Effectiveness of bariatric surgery in diabetes prevention in high-risk Asian individuals. Singapore Med J 2018 Sep;59(9):472-5. doi: 10.11622/smedj.2018110.
CLVIII. Dicker D, Comaneshter DS, Yahalom R et al. Conversion from prediabetes to diabetes in individuals with obesity, 5-years post-band, sleeve, and gastric bypass surgeries. Obes Surg 2019 Dec;29(12):3901-6. doi: 10.1007/s11695-019-04090-1.
CLIX. Kunz-Martínez W, Pérez-Pacheco AI. Bipartición de tránsito intestinal, la nueva era de la cirugía metabólica para la diabetes mellitus de tipo 2. Rev Colomb Cir 2018 Oct 24;33(4):406-20.
CLX. Grams J, Garvey WT. Weight loss and the prevention and treatment of type 2 diabetes using lifestyle therapy, pharmacotherapy, and bariatric surgery: mechanisms of action. Curr Obes Rep 2015 Jun;4(2):287-302. doi: 10.1007/s13679-015-0155-x.
CLXI. Lee CJ, Florea L, Sears CL et al. Changes in gut microbiome after bariatric surgery vs. medical weight loss in a pilot randomized Trial. Obes Surg 2019 Oct;29(10):3239-45. doi: 10.1007/s11695-019-03976-4.
CLXII. Hayoz C, Hermann T, Raptis DA, et al. Comparison of metabolic outcomes in patients undergoing laparoscopic roux-en-Y gastric bypass versus sleeve gastrectomy - a systematic review and meta-analysis of randomised controlled trials. Swiss Med Wkly 2018 Jul 5;148:w14633. doi: 10.57187/smw.2018.14633.
CLXIII. Ashrafian H, Athanasiou T, Li JV, et al. Diabetes resolution and hyperinsulinaemia after metabolic Roux-en-Y gastric bypass. Obes Rev 2011 May;12(5):e257-72. doi: 10.1111/j.1467-789X.2010.00802.x.
CLXIV. Park CH, Nam SJ, Choi HS et al. Comparative efficacy of bariatric surgery in the treatment of morbid obesity and diabetes mellitus: a systematic review and network meta-analysis. Obes Surg 2019 Jul;29(7):2180-90. doi: 10.1007/s11695-019-03831-6
CLXV. Pareek M, Schauer PR, Kaplan LM et al. Metabolic surgery: weight loss, diabetes, and beyond. J Am Coll Cardiol 2018 Feb 13;71(6):670-87. doi: 10.1016/j.jacc.2017.12.014.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 on behalf of the authors. Reproduction rights: Argentine Diabetes Society
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Dirección Nacional de Derecho de Autor, Exp. N° 5.333.129. Instituto Nacional de la Propiedad Industrial, Marca «Revista de la Sociedad Argentina de Diabetes - Asociación Civil» N° de concesión 2.605.405 y N° de disposición 1.404/13.
La Revista de la SAD está licenciada bajo Licencia Creative Commons Atribución – No Comercial – Sin Obra Derivada 4.0 Internacional.
Por otra parte, la Revista SAD permite que los autores mantengan los derechos de autor sin restricciones.
