Among patients with type 2 diabetes, bariatric surgery has been the subject of considerable interest because of its favorable effects on glucose metabolism. Indeed, various procedures have been associated with high rates of diabetes remission (1), although the outcomes of these studies have been assessed in a heterogeneous manner (2). Despite the favorable results overall, there has been divergence among procedures regarding improvement of diabetes (1). This observation raises the possibility of identifying underlying mechanisms leading to improved glucose metabolism as a means to identify new diabetes treatments. The patho-physiology underlying development of type 2 diabetes includes defects in insulin secretion, disordered postprandial suppression of glucagon secretion, and defects in insulin action and glucose effectiveness (the ability of insulin and glucose to stimulate glucose uptake and suppress glucose release) (3). The heterogeneous effects of various forms of bariatric surgery on these parameters remain a topic of intense interest.
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