Diabetes and obesity: A debate on bariatric interventions and its implications

In this editorial, we comment on an article by Tang et al published in the World Journal of Diabetes. Obesity and diabetes are two pathological situations that are intrinsically related. Neither lifestyle changes nor pharmacological treatments have achieved diabetes remission. From this perspective, bariatric surgery has been widely used as an approach for weight loss in obese patients and as a strategy to promote metabolic modulation. The main effects of bariatric surgery involve direct action in improving cardiovascular function and endothelial function and reducing insulin resistance, leading to diabetes remission in the short term following surgery. In this context, it has been observed that hormones from the gastrointestinal tract and endothelium play a prominent role in this process. By reversing endothelial dysfunction, it is possible to balance pro-inflammatory cytokine production, improving the availability of nitric oxide and inhibiting vascular oxidative stress. Furthermore, it can be considered an efficient anti-inflammatory strategy, alleviating interferon-gamma-mediated adipose tissue inflammation. The current challenge must be to unravel the pathophysiological mechanisms and potential targets for treating metabolic diseases.