[Bariatric surgeries at diabetic patients]

A worldwide increase in the prevalence of obesity and type 2 diabetes mellitus along with accompanying chronic, in particular cardiovascular, complications represents one of the leading challenges of current medicine. Despite major advances in diabetes pharmacotherapy, bariatric surgery remains the most effective treatment of diabetes. It not only markedly decreases body weight and improves glucose control but also induces diabetes remission in a significant percentage of patients. According to current recommendations, bariatric surgery is indicated in patients with 3rd degree obesity (even without any complications) or with 2nd degree obesity with complications (e.g. diabetes, dyslipidemia etc.). There is a growing body of evidence that bariatric surgery is efficacious also in type 2 diabetics with 1st degree obesity or even with BMI bellow 30 kg/m2. This paper summarizes practical aspects of indications of diabetics to different types of bariatric operations and their long-term follow up. It also discusses the differences between various types of operations and their mechanisms of positive metabolic effects.Key words: bariatric surgery - cardiovascular complications - diabetes remission - mechanisms of action - type 2 diabetes mellitus.