[Consensus statement of the Chilean endocrinological society on the role of bariatric surgery in type 2 diabetes].

Autor: Sapunar J; Departamento de Medicina Interna y Centro EPICYN, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile., Escalona A; Clínica Universidad de los Andes, Facultad de Medicina, Universidad de los Andes, Santiago, Chile., Araya AV; Hospital Clínico, Universidad de Chile, Santiago, Chile., Aylwin CG; Clínica Universidad de los Andes, Facultad de Medicina, Universidad de los Andes, Santiago, Chile., Bastías MJ; Sección Endocrinología, Diabetes y Nutrición, Departamento de Medicina Interna, Hospital Naval Almirante Nef, Viña del Mar, Chile., Boza C; Clínica Las Condes, Santiago, Chile., Cárcamo C; Instituto de Cirugía, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile., Csendes A A; Hospital Clínico, Universidad de Chile, Santiago, Chile., Davidof F P; Hospital FACH, Santiago, Chile., Funke R; Clínica Las Condes, Santiago, Chile., Gómez P; Hospital Clínico, Universidad de Chile, Santiago, Chile., González MI; Clínica Sanatorio Alemán, Concepción, Chile., Lahsen R; Clínica Las Condes, Santiago, Chile., Lanzarini E; Hospital Clínico, Universidad de Chile, Santiago, Chile., Maíz A; Departamento. Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Mujica V; Facultad de Medicina, Universidad Católica del Maule, Talca, Chile., Muñoz R; Departamento de Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Pérez G; Departamento de Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile., Raimann F; Centro Integral de Obesidad y Diabetes, Servicio de Cirugía y Endoscopía, Clínica Puerto Varas, Puerto Varas, Chile., Salman P; Unidad de Endocrinología, Departamento de Medicina Interna, Facultad de Medicina. universidad de Concepción. Concepción, Chile., Sepúlveda M; Hospital de la Dirección de Previsión de Carabineros de Chile (DIPRECA). Santiago, Chile., Soto N; Unidad de Endocrinología y Diabetes, Servicio de Medicina Interna, Hospital San Borja Arriarán. Santiago, Chile., Villagrán R; Departamento de Cirugía Bariátrica Metabólica, Clínica Bupa Antofagasta. Antofagasta, Chile.
Jazyk: Spanish; Castilian
Zdroj: Revista medica de Chile [Rev Med Chil] 2018 Dec; Vol. 146 (10), pp. 1175-1183.
DOI: 10.4067/S0034-98872018001001175
Abstrakt: Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.
Databáze: MEDLINE
Externí odkaz: