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Can Roux-en-Y gastric bypass provide a lifelong solution for diabetes mellitus?Hussain A; Mahmood H; El-Hasani SCan J Surg 2009[Dec]; 52 (6): E269-75BACKGROUND: The surgical treatment of diabetes had witnessed progressive development and success since the first case of pancreatic transplantation. Although this was a great step, wide clinical application was limited by several factors. Bariatric surgery such as gastric bypass is emerging as a promising option in obese patients with type 2 diabetes. The aim of this article is to explore the current application of gastric bypass in patients with type 2 diabetes and the theoretical bases of gastric bypass as a treatment option for type 1 diabetes. METHODS: We performed a MEDLINE search for articles published from August 1955 to December 2008 using the words "surgical treatment of diabetes," "etiology of diabetes" and "gastric bypass." RESULTS: We identified 3215 studies and selected 72 relevant papers for review. Surgical treatment of diabetes is evolving from complex pancreatic and islets transplantation surgery for type 1 diabetes with critical postoperative outcome and follow-up to a metabolic surgery, including gastric bypass. Gastric bypass (no immune suppression or graft rejection) has proven to be highly effective treatment for obese patients and nonobese animals with type 2 diabetes. There are certain shared criteria between types 1 and 2 diabetes, making a selected spectrum of the disease a potential target for metabolic surgery to improve or cure diabetes. CONCLUSION: Roux-en-Y gastric bypass is a promising option for lifelong treatment of type 2 diabetes. It has the potential to improve or cure a selected spectrum of type 1 diabetes when performed early in the disease. Further animal model studies or randomized controlled trials are needed to support our conclusion.|*Gastric Bypass[MESH]|Diabetes Mellitus, Type 1/complications/*surgery[MESH]|Diabetes Mellitus, Type 2/complications/*surgery[MESH]|Humans[MESH]|Obesity, Morbid/complications/*surgery[MESH] |