Changes of Guidelines in the Management of Obese Patients With Diabetes in the Metabolic Surgery Perspective.
Bu Kyung KimKyung Won SeoPublished in: Journal of metabolic and bariatric surgery (2022)
Recently, metabolic surgery was recommended for patients with a BMI of 30 or higher and 27.5 or higher for Asians, as evidence level A. Until 2008, bariatric surgery was not introduced for the treatment of diabetes. Bariatric surgery was first recommended for adults with body mass index ≥35 kg/m 2 and type 2 diabetes in the American Diabetes Association (ADA) guidelines as evidence level B in 2009. In 2017, the terminology was changed from bariatric surgery to metabolic surgery. How such large changes could have occurred in the ADA guidelines? Because many patients have reached diabetes remission through metabolic surgery, and the long-term benefit and cost-effectiveness have been strongly proven by historical randomized controlled trials and high-quality studies. This review demonstrates how the recommendations for the treatment of obesity in patients with diabetes have changed in diabetes treatment guidelines and summarizes the evidence behind this change.
Keyphrases
- type diabetes
- bariatric surgery
- minimally invasive
- weight loss
- glycemic control
- body mass index
- cardiovascular disease
- coronary artery bypass
- clinical practice
- obese patients
- metabolic syndrome
- insulin resistance
- surgical site infection
- newly diagnosed
- adipose tissue
- end stage renal disease
- clinical trial
- combination therapy
- physical activity
- coronary artery disease
- atrial fibrillation
- peritoneal dialysis
- replacement therapy
- high fat diet induced