International Diabetes Foundation Position Statement on Metabolic Surgery in The Treatment of T2DM

The International Diabetes Foundation (IDF) released a Position Statement calling for metabolic surgery to be considered early in the treatment of T2DM.

The document recognized that:

  • In addition to behavioral and medical treatments, metabolic surgeries constitute a powerful option to ameliorate diabetes in patients affected by severe obesity.
  • Metabolic surgery is an appropriate treatment for people with T2DM and obesity not achieving recommended treatment targets with medical therapies
  • Surgery should be an accepted option in people who have T2DM and a BMI of 35 or more.
  • Surgery should be considered as an alternative treatment option in patients with a BMI between 30 and 35 when T2DM cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors.
  • The risk for complications and death with metabolic surgery is low and similar to that of well-accepted procedures such as gallbladder surgery

Metabolic and diabetes surgery for T2DM must be performed within accepted guidelines which include an ongoing multidisciplinary care, patient education, follow-up and clinical audit, as well as safe and effective surgical procedures.

Guidelines endorsed by the Australian Diabetes Society

Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations

The ADS has recently endorsed international guidelines that recommend metabolic surgery for patients with type 2 diabetes and class III (BMI ≥40 kg/m2) obesity and patients with type 2 diabetes with class II (BMI 35.0–39.9 kg/m2) obesity who have had inadequate glycaemic control with lifestyle and pharmacotherapy.

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Metabolic Surgery Linked to Fewer CV Events in Patients With Type 2 Diabetes and Obesity.

Surgery for Type 2 Diabetes.

The American Diabetes Association 2017 Standards of Medical Care in Diabetes addresses important new issues in diabetes care, including metabolic surgery and a more specific definition of hypoglycemia.

Addressing Obesity Stigma and Metabolic Surgery in T2D: Takeaways From WCITD 2019

Relationship between metabolic surgery and major adverse cardiovascular events (MACE) in patients with type 2 diabetes and obesity.

2287 patients of the total of 2,87,438 adult patients with diabetes in the Cleveland Clinic Health System in the United States between 1998 and 2017 underwent metabolic surgery.

Metabolic surgery (MS) can be a useful therapeutic strategy in patients with type 2 diabetes (DM2) and obesity.

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