Translational Endocrinology & Metabolism: Metabolic Surgery

A comprehensive review on the impact of metabolic surgery on the treatment of severe endocrine diseases.

June, 2012, Guest Editors:
Francesco Rubino, MD
David E. Cummings, MD

Target Audience

This continuing medical education activity should be of substantial interest to endocrinologists, surgeons, and other physicians and allied healthcare providers treating metabolic surgery patients.

Learning Objectives

Upon completion of this educational activity, learners will be able to:

  • Identify the ethical and practical issues involved in developing a high-quality evidence base for diabetes/metabolic surgery.
  • Select and prioritize patients for diabetes/metabolic surgery.
  • Summarize the variability in clinical response of diabetes- and obesity-related comorbid conditions to diabetes/metabolic surgery.
  • Explain the complex nature of and necessity for personalized approaches to pharmacologic treatment of type 2 diabetes mellitus.
  • Assess the benefits and risks associated with the use of pharmacologic therapy for type 2 diabetes mellitus.
  • Assess the effectiveness of diabetes therapy on the basis of clinical outcomes, rather than relying solely on surrogate measurements such as hemoglobin A1c and glucose profiles.
  • Rank effectiveness of bariatric procedures in inducing remission of type 2 diabetes mellitus.
  • Compare metabolic surgery with medical management for the treatment of type 2 diabetes mellitus.
  • Define the mechanisms by which various bariatric procedures result in intended outcomes.
  • Analyze evidence for the existence of weight loss-independent anti-diabetes mechanisms mediating improved glucose homeostasis and remission of type 2 diabetes mellitus after bariatric/metabolic surgery.
  • Become familiar with some of the candidate hormonal and metabolic mechanisms to explain the weight loss-independent anti-diabetes effects of metabolic surgery. .
  • Evaluate use of metabolic surgery to treat type 2 diabetes mellitus in patients with a body mass index less than 35 kg/m2.

Additional Information

Target Audience: 
Clinical researcher
Scientific researcher
Nurse/Nurse practitioner
Physician assistant
Allied health professional
Competency Area: 
Patient Care and Procedural Skills
Medical Knowledge
Topic Area: 
General Endocrinology
Level of Outcomes: 
Level 1 (Participation)
Level 2 (Satisfaction)
Level 3A (Learning: Declarative Knowledge (Knows))
Level 3B (Learning: Procedural Knowledge (Knows How))
Level 4 (Learning: Competence (Shows How))
Activity summary
Available credit: 
  • 8.00 AMA PRA Category 1 Credits
  • 8.00 CME Certificate of Participation
Course opens: 
Course expires: 


As a provider of continuing medical education (CME) accredited by the Accreditation Council for Continuing Medical Education, The Endocrine Society has a policy of ensuring that the content and quality of this educational activity are balanced, independent, objective, and scientifically rigorous. The scientific content of this activity was developed under the supervision of Editor-in-Chief, Dr. Paul Robertson, and Guest Editors, Dr. David E. Cummings and Dr. Francesco Rubino.



The faculty, committee members, and staff who are in position to control the content of this activity are required to disclose to The Endocrine Society and to learners any relevant financial relationship(s) of the individual or spouse/partner that have occurred within the last 12 months with any commercial interest(s) whose products or services are related to the CME content. Financial relationships are defined by remuneration in any amount from the commercial interest(s) in the form of grants; research support; consulting fees; salary; ownership interest (e.g., stocks, stock options, or ownership interest excluding diversified mutual funds); honoraria or other payments for participation in speakers' bureaus, advisory boards, or boards of directors; or other financial benefits. The intent of this disclosure is not to prevent CME planners with relevant financial relationships from planning or delivery of content, but rather to provide learners with information that allows them to make their own judgments of whether these financial relationships may have influenced the educational activity with regard to exposition or conclusion.

The Endocrine Society has reviewed all disclosures and resolved or managed all identified conflicts of interest, as applicable.

The following faculty reported relevant financial relationships:

Stefano Del Prato , MD: advisory panel for AstraZeneca LP, Boehringer Ingelheim, Bristol-Myers Squibb Company, Eli Lilly and Company, GlaxoSmithKline, Merck & Co. Inc, Novartis Pharmaceuticals Corporation, Novo Nordisk A/S, Roche Pharmceuticals; research support for Merck & Co. Inc., Novo Nordisk A/S, sanofi-aventis; speakers bureau for GlaxoSmithKline and sanofi-aventis

John B. Dixon , MBBS, PhD: consultant for Allergan Inc.

Harold E Lebovitz , MD, FACE: consultant and stock holder for Merck Sharpe & Dome, consultant for Poxel Pharma, international speaker for Astra-Zenica and Sanofi, stock holder for Abbott, and speaker for Ethicon Surgical

Francesco Rubino, MD: advisory board member for NGM Biotech

The following faculty reported no relevant financial relationships: Stacey Alan Brethauer, MD; David E. Cummings, MD; SHAI MERON ELDAR, MD; Helen M. Heneghan, MD; Philip Raymond Schauer, MD

Editor-in-Chief, Paul Robertson, MD, who planned and reviewed content for this activity, reported no relevant financial relationships.

Endocrine Society staff associated with the development of content for this activity reported no relevant financial relationships.


The information presented in this activity represents the opinion of the faculty and is not necessarily the official position of The Endocrine Society.

Use of professional judgment:

The educational content in this activity relates to basic principles of diagnosis and therapy and does not substitute for individual patient assessment based on the health care provider’s examination of the patient and consideration of laboratory data and other factors unique to the patient. Standards in medicine change as new data become available.

Drugs and dosages:

When prescribing medications, the physician is advised to check the product information sheet accompanying each drug to verify conditions of use and to identify any changes in drug dosage schedule or contraindications.



The Endocrine Society has determined that disclosure of unlabeled/off-label or investigational use of commercial product(s) is informative for audiences and therefore requires this information to be disclosed to the learners at the beginning of the presentation. Uses of specific therapeutic agents, devices, and other products discussed in this educational activity may not be the same as those indicated in product labeling approved by the Food and Drug Administration (FDA). The Endocrine Society requires that any discussions of such “off-label” use be based on scientific research that conforms to generally accepted standards of experimental design, data collection, and data analysis. Before recommending or prescribing any therapeutic agent or device, learners should review the complete prescribing information, including indications, contraindications, warnings, precautions, and adverse events.



The Endocrine Society will record learner's personal information as provided on CME evaluations to allow for issuance and tracking of CME certificates. The Endocrine Society may also track aggregate responses to questions in activities and evaluations and use these data to inform the ongoing evaluation and improvement of its CME program. No individual performance data or any other personal information collected from evaluations will be shared with third parties.



This activity is not supported by educational grants.

Available Credit

  • 8.00 AMA PRA Category 1 Credits
  • 8.00 CME Certificate of Participation