Diabetes mellitus surgery: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Diabetes mellitus }} | {{Diabetes mellitus }} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]; {{CZ}} | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh13579@gmail.com]; {{CZ}} {{KGH}} | ||
==Overview== | ==Overview== | ||
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|accessdate=2007-09-26 | |accessdate=2007-09-26 | ||
}}</ref> | }}</ref> | ||
== 2013 American Diabetes Association Standards of Medical Care in Diabetes (DO NOT EDIT)<ref name="pmid23264422">{{cite journal| author=American Diabetes Association| title=Standards of medical care in diabetes--2013. | journal=Diabetes Care | year= 2013 | volume= 36 Suppl 1 | issue= | pages= S11-66 | pmid=23264422 | doi=10.2337/dc13-S011 | pmc=PMC3537269 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23264422 }} </ref>== | |||
===Bariatric Surgery=== | |||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''1.''' Bariatric surgery may be considered for adults with BMI 35 kg/m2 and type 2 diabetes, especially if the diabetes or associated comorbidities are difficult to control with lifestyle and pharmacological therapy. ''([[ADA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''2.''' Patients with type 2 diabetes who have undergone bariatric surgery need life- long lifestyle support and medical monitoring. ''([[ADA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | |||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''3.''' Although small trials have shown gly-cemic benefit of bariatric surgery in patients with type 2 diabetes and BMI 30–35 kg/m2, there is currently insufficient evidence to generally recommend surgery in patients with BMI <35 kg/m2 outside of a research protocol. ''([[ADA guidelines classification scheme#Level of Evidence|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
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| bgcolor="Seashell"|<nowiki>"</nowiki>'''4.''' The long-term benefits, cost-effectiveness, and risks of bariatric surgery in individuals with type 2 diabetes should be studied in well-designed controlled trials with optimal medical and lifestyle therapy as the comparator. ''([[ADA guidelines classification scheme#Level of Evidence|Level of Evidence: E]])''<nowiki>"</nowiki> | |||
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==References== | ==References== | ||
Revision as of 22:40, 16 December 2013
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Diabetes mellitus Main page |
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Patient Information |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]; Cafer Zorkun, M.D., Ph.D. [3] Karol Gema Hernandez, M.D. [4]
Overview
Type 2 diabetes can be cured by one type of gastric bypass surgery in 80-100% of severely obese patients. The effect is not due to weight loss because it usually occurs within days of surgery, which is before significant weight loss occurs. The pattern of secretion of gastrointestinal hormones is changed by the bypass and removal of the duodenum and proximal jejunum, which together form the upper (proximal) part of the small intestine.[1] One hypothesis is that the proximal small intestine is dysfunctional in type 2 diabetes; its removal eliminates the source of an unknown hormone that contributes to insulin resistance.[2] This surgery has been widely performed on morbidly obese patients and has the benefit of reducing the death rate from all causes by up to 40%.[3] A small number of normal to moderately obese patients with type 2 diabetes have successfully undergone similar operations.[4][5]
2013 American Diabetes Association Standards of Medical Care in Diabetes (DO NOT EDIT)[6]
Bariatric Surgery
| "1. Bariatric surgery may be considered for adults with BMI 35 kg/m2 and type 2 diabetes, especially if the diabetes or associated comorbidities are difficult to control with lifestyle and pharmacological therapy. (Level of Evidence: B)" |
| "2. Patients with type 2 diabetes who have undergone bariatric surgery need life- long lifestyle support and medical monitoring. (Level of Evidence: B)" |
| "3. Although small trials have shown gly-cemic benefit of bariatric surgery in patients with type 2 diabetes and BMI 30–35 kg/m2, there is currently insufficient evidence to generally recommend surgery in patients with BMI <35 kg/m2 outside of a research protocol. (Level of Evidence: E)" |
| "4. The long-term benefits, cost-effectiveness, and risks of bariatric surgery in individuals with type 2 diabetes should be studied in well-designed controlled trials with optimal medical and lifestyle therapy as the comparator. (Level of Evidence: E)" |
References
- ↑ Rubino, F (2002). "Potential of surgery for curing type 2 diabetes mellitus". Ann. Surg. 236 (5): 554–9. ISSN 0003-4932. PMID 12409659. Unknown parameter
|coauthors=ignored (help) - ↑ Rubino, F (2006). "The mechanism of diabetes control after gastrointestinal bypass surgery reveals a role of the proximal small intestine in the pathophysiology of type 2 diabetes". Ann. Surg. 244 (5): 741–9. PMID 17060767. Unknown parameter
|coauthors=ignored (help) - ↑ Adams, TD (2007). "Long-term mortality after gastric bypass surgery". N. Engl. J. Med. 357 (8): 753–61. doi:10.1056/NEJMoa066603. ISSN 0028-4793. PMID 17715409. Unknown parameter
|coauthors=ignored (help) - ↑ Cohen, RV (2007). "Duodenal-jejunal bypass for the treatment of type 2 diabetes in patients with body mass index of 22-34 kg/m2: a report of 2 cases". Surg Obes Relat Dis. 3 (2): 195–7. doi:10.1016/j.soard.2007.01.009. PMID 17386401. Unknown parameter
|coauthors=ignored (help) - ↑ Vasonconcelos, Alberto (2007-09-01). "Could type 2 diabetes be reversed using surgery?". New Scientist (2619): 11–13. Retrieved 2007-09-26. Check date values in:
|date=(help) - ↑ American Diabetes Association (2013). "Standards of medical care in diabetes--2013". Diabetes Care. 36 Suppl 1: S11–66. doi:10.2337/dc13-S011. PMC 3537269. PMID 23264422.