胃肠病学家会成为成功的代谢内科医生吗?

M. Sharbaugh, T. Shope, T. Koch
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摘要

由于治疗不完全,肥胖仍然是包括代谢紊乱在内的多种医学问题的世界性根源。随着世界范围内肥胖的增加,2型糖尿病的患病率在男性和女性中都有所增加。对肥胖的有效治疗可以改善代谢紊乱的治疗。可调节胃束和垂直袖胃切除术是较简单的胃手术,被减肥外科医生用于治疗代谢紊乱。研究支持这两种胃手术治疗糖尿病患者亚群的效用。胃肠病学领域主要研究了治疗肥胖的四种主要内窥镜手术:胃内气囊、胃内吸吸系统、胃腔内缝合和在上小肠内部署腔内屏障。正在进行的研究正在检验这些内窥镜手术治疗代谢性疾病的能力,其中包括糖尿病患者血液中血红蛋白A1C水平的降低。讨论了在广泛应用内窥镜手术治疗这种代谢紊乱之前应该解决的持续问题。
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Will Gastroenterologists Be Successful as Metabolic Physicians?
As the result of incomplete treatments, obesity continues to be a worldwide origin for multiple medical problems, including metabolic disorders. With the worldwise rise in obesity, the prevalence of type 2 diabetes mellitus has increased in both men and women. Effective treatments for obesity can improve the treatment of metabolic disorders. The adjustable gastric band and the vertical sleeve gastrectomy are less complex gastric surgeries utilized by bariatric surgeons for the treatment of metabolic disorders. Studies have supported the utility of both of these gastric surgeries for the treatment of subgroups of individuals with diabetes mellitus. The field of gastroenterology has mainly been examining four major endoscopic procedures for the treatment of obesity: intragastric balloons, intragastric aspiration systems, intraluminal gastric suturing, and intraluminal barriers deployed within the upper small intestine. Ongoing studies are examining the ability of these endoscopic procedures to treat metabolic disorders, which includes reduction in the blood levels of hemoglobin A1C in individuals with diabetes mellitus. Ongoing issues are discussed that should be addressed prior to the wide spread utilization of endoscopic procedures for the treatment of this metabolic disorder.
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