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Abstract
Recent studies have shown that bariatric surgery can lead to the remission of diabetes in a large portion of patients with type 2 diabetes and morbid obesity. The effect of bariatric surgery, especially Roux-en-Y gastric bypass, is thought to be caused by mechanisms other than weight loss that contribute to the metabolic improvement. Improvement in hepatic insulin resistance which is thought to be linked to caloric restriction in the initial period after surgery and improved peripheral insulin resistance seen with weight loss are one of the mechanisms leading to improved metabolism. Insulin secretion and altered gut hormone secretion also seem to play a role in this improvement. The mechanisms underlying the beneficial effect of bariatric surgery need to be further studied and this increased understanding will aid in the understanding of the pathophysiology of type 2 diabetes, and may lead to the development of novel therapies.
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