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

Publication date: Available online 7 August 2019Source: Journal of Visceral SurgeryAuthor(s): F. Galtier, F. Pattou, S. Czernichow, E. Disse, P. Ritz, J.-M. Chevallier, E. Cosson, P. Valensi, F. Andreelli, M. Robert, DIAMS study groupSummaryBackgroundMetabolic surgery is now considered as a therapeutic option in type 2 diabetes (T2D). However, few data are available regarding perioperative management of T2D.ObjectivesTo assess current practice among bariatric teams regarding perioperative management of T2D in order to propose guidelines.MethodsA 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.ResultsA total of 170 experts participated. Experts favored gastric bypass to achieve remission (76.7%). Screening for retinopathy, cardiac ultrasound, and reaching an HbA1c 
Source: Journal of Visceral Surgery - Category: Surgery Source Type: research

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