Cirurgia metabólica no controle do diabetes mellitus tipo 2: evidências clínicas, mecanismos endócrino-metabólicos e implicações terapêuticas
DOI:
https://doi.org/10.36557/2674-8169.2025v7n10p1597-1613Palavras-chave:
Cirurgia bariátrica, diabetes tipo 2, obesidade, custo-efetividade., Complicações, Cirurgia, Diabetes, DiabetesResumo
O Diabetes Mellitus tipo 2 (DM2) apresenta alta prevalência e controle limitado com terapias convencionais. A cirurgia metabólica desponta como alternativa eficaz ao atuar na modulação endócrino-intestinal, independentemente da perda de peso. Objetivo: Avaliar evidências sobre eficácia e mecanismos fisiopatológicos da cirurgia metabólica no controle do DM2. Metodologia: Realizou-se revisão integrativa nas bases PubMed, Scopus e ScienceDirect (2010–2025), incluindo ensaios clínicos, coortes e revisões sistemáticas que avaliaram desfechos glicêmicos (HbA1c, HOMA-IR). Resultados: Nove estudos atenderam aos critérios. Observou-se redução média de HbA1c de 2–3 p.p. e remissão do DM2 em até 90%, associadas à elevação de incretinas (GLP-1, PYY), redução da grelina e ativação das vias SIRT1/p62 e FXR/TGR5. Conclusão: A cirurgia metabólica configura intervenção endócrino-metabólica de alta eficácia, restaurando a função β-pancreática e a homeostase glicêmica, embora exija estudos multicêntricos para padronização e ampliação das indicações.
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Copyright (c) 2025 Fábio Ricardo Martins do Nascimento Júnior, Victoria Dantas dos Santos Barbedo, Laura Peruzzo batata, Gabriel Henrique Rial, Fabiana Pereira de bettio , Ian Passos alves , Suzane de Cássia Brito Rodrigues , Dario Da Cruz Machado Júnior , Ivo Ernesto Oleari Almeida Frazão Tolentino, Guilherme Sousa da Silva , Maria Helena Gaya Pitz , Talyta Borges Cordeiro , Marcelo Marcony leal de Lima filho , Clara Monalisa Medeiros Brandão
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Os autores são detentores dos direitos autorais mediante uma licença CCBY 4.0.
