Bariatric surgery and the perioperative management of type 2 diabetes: Practical guidelines.

Adult Bariatric Surgery Blood Glucose / metabolism Delphi Technique Diabetes Mellitus, Type 2 / surgery Female France Humans Hypoglycemic Agents / therapeutic use Male Middle Aged Postoperative Care Practice Patterns, Physicians' / statistics & numerical data
Bariatric surgery Diabetes Guidelines Metabolic surgery

Journal

Journal of visceral surgery
ISSN: 1878-7886
Titre abrégé: J Visc Surg
Pays: France
ID NLM: 101532664

Informations de publication

Date de publication:
Feb 2020
Historique:
pubmed: 12 8 2019
medline: 1 6 2021
entrez: 12 8 2019
Statut: ppublish

Résumé

Metabolic surgery is now considered as a therapeutic option in type 2 diabetes (T2D). However, few data are available regarding perioperative management of T2D. To assess current practice among bariatric teams regarding perioperative management of T2D in order to propose guidelines. A two-round Delphi method using online surveys was employed among bariatric teams experts (surgeons, diabetologists, anesthetists, nutritionists): first round, 63 questions covering 6 topics (characteristics of experts/teams, characteristics of patients, operative technique, pre/postoperative management, diabetes remission); second round, 44 items needing clarification. They were discussed within national congress of corresponding learned societies. Consensus was defined as ≥66% agreement. A total of 170 experts participated. Experts favored gastric bypass to achieve remission (76.7%). Screening for retinopathy, cardiac ultrasound, and reaching an HbA Rapid postoperative modifications of blood glucose require a close monitoring and a prompt adjustment of diabetes medications.

Sections du résumé

BACKGROUND BACKGROUND
Metabolic surgery is now considered as a therapeutic option in type 2 diabetes (T2D). However, few data are available regarding perioperative management of T2D.
OBJECTIVES OBJECTIVE
To assess current practice among bariatric teams regarding perioperative management of T2D in order to propose guidelines.
METHODS METHODS
A two-round Delphi method using online surveys was employed among bariatric teams experts (surgeons, diabetologists, anesthetists, nutritionists): first round, 63 questions covering 6 topics (characteristics of experts/teams, characteristics of patients, operative technique, pre/postoperative management, diabetes remission); second round, 44 items needing clarification. They were discussed within national congress of corresponding learned societies. Consensus was defined as ≥66% agreement.
RESULTS RESULTS
A total of 170 experts participated. Experts favored gastric bypass to achieve remission (76.7%). Screening for retinopathy, cardiac ultrasound, and reaching an HbA
CONCLUSION CONCLUSIONS
Rapid postoperative modifications of blood glucose require a close monitoring and a prompt adjustment of diabetes medications.

Identifiants

DOI: 10.1016/j.jviscsurg.2019.07.012 PMID: 31401070
pubmed: 31401070
pii: S1878-7886(19)30124-9
doi: 10.1016/j.jviscsurg.2019.07.012
pii:
doi:

Substances chimiques

Blood Glucose 0
Hypoglycemic Agents 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

13-21

Informations de copyright

Copyright © 2019 Elsevier Masson SAS. All rights reserved.

Auteurs

F Galtier (F)

CHU Montpellier, Centre d'Investigation Clinique et Département des Maladies Endocriniennes, Inserm, CIC 1411, Hôpital St Éloi, 90, avenue Augustin-Fliche, 34295 Montpellier cedex 05, France. Electronic address: f-galtier@chu-montpellier.fr.

F Pattou (F)

University of Lille, CHU Lille Endocrine and Metabolic Surgery, Inserm UMR 1190 Translational Research for Diabetes, 2, avenue Oscar-Lambret, 59000 Lille, France.

S Czernichow (S)

Department of Nutrition, Hôpital européen Georges Pompidou (APHP), Centre Spécialisé Obésité Ile de France Sud; University Paris Descartes; Inserm UMR 1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (METHODS team), 20, rue Leblanc, 75015 Paris, France.

E Disse (E)

Fédération Hospitalo-Universitaire DO-IT, Centre Intégré et Spécialisé de L'Obésité de Lyon, Université Lyon 1, CRNH-RA, Hospices Civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.

P Ritz (P)

Centre Intégré Obésité, CHU de Toulouse, Inserm U1027, Université Paul Sabatier, route de Narbonne, 31330 Toulouse, France.

J-M Chevallier (JM)

Department of Digestive surgery, Hôpital Européen Georges Pompidou (APHP), Centre Spécialisé Obésité Ile de France Sud; University Paris 5, 20, rue Leblanc, 75015 Paris, France.

E Cosson (E)

Department of endocrinology, diabetology and nutrition, hôpital Jean-Verdier (AP-HP), Paris 13 university, Sorbonne Paris Cité, CRNH-IdF, CINFO, avenue du 14-Juillet, 93140 Bondy, France; UMR U1153 Inserm, U1125 Inra, CNAM, Sorbonne Paris Cité, Paris 13 university, 74, rue Marcel-Cachin, 93017 Bobigny cedex, France.

P Valensi (P)

Department of endocrinology, diabetology and nutrition, hôpital Jean-Verdier (AP-HP), Paris 13 university, Sorbonne Paris Cité, CRNH-IdF, CINFO, avenue du 14-Juillet, 93140 Bondy, France.

F Andreelli (F)

Cardiometabolism and Nutrition Institute (ICAN), Heart and Metabolism Department, Pitié-Salpêtrière Hospital (APHP), 47-83, boulevard de l'Hôpital, 75013 Paris, France; Inserm UMRS U1166 (Eq 6) Nutriomics, UPMC, Pierre et Marie Curie Faculty Paris 6, Sorbonne University, 91 et 105, boulevard de l'Hôpital, 75013 Paris, France.

M Robert (M)

Inserm UMRS U1166 (Eq 6) Nutriomics, UPMC, Pierre et Marie Curie Faculty Paris 6, Sorbonne University, 91 et 105, boulevard de l'Hôpital, 75013 Paris, France; Department of Digestive Surgery, Center of Bariatric Surgery, Hospital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Fédération Hospitalo-Universitaire DO-IT, Centre Intégré et Spécialisé de L'Obésité de Lyon, Université Lyon 1, CRNH-RA, Hospices Civils de Lyon, 165, chemin du Grand-Revoyet, 69310 Pierre-Bénite, France.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Bariatric surgery and the perioperative...
questionsmedicales.fr › Procédures de chirurgie opératoire › Chirurgie bariatrique › Bariatric surgery and the perioperative...
questionsmedicales.fr › Glucides › Sucres › Oses › Hexose › Glucose › Glycémie › Bariatric surgery and the perioperative...
questionsmedicales.fr › Sciences de l'information › Analyse des systèmes › Méthode Delphi › Bariatric surgery and the perioperative...
questionsmedicales.fr › Maladies endocriniennes › Diabète › Diabète de type 2 › Bariatric surgery and the perioperative...
questionsmedicales.fr › Régions géographiques › Europe › France › Bariatric surgery and the perioperative...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Bariatric surgery and the perioperative...
questionsmedicales.fr › Actions chimiques et utilisations › Actions pharmacologiques › Effets physiologiques des médicaments › Hypoglycémiants › Bariatric surgery and the perioperative...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Bariatric surgery and the perioperative...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Services de santé › Soins aux patients › Soins périopératoires › Soins postopératoires › Bariatric surgery and the perioperative...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Types de pratiques des médecins › Bariatric surgery and the perioperative...