RESUMEN
The International Diabetes Federation Taskforce on Epidemiology and Prevention of Diabetes convened a consensus working group of diabetologists, endocrinologists, surgeons and public health experts to review the appropriate role of surgery and other gastrointestinal interventions in the treatment and prevention of Type 2 diabetes. The specific goals were: to develop practical recommendations for clinicians on patient selection; to identify barriers to surgical access and suggest interventions for health policy changes that ensure equitable access to surgery when indicated; and to identify priorities for research. Bariatric surgery can significantly improve glycaemic control in severely obese patients with Type 2 diabetes. It is an effective, safe and cost-effective therapy for obese Type 2 diabetes. Surgery can be considered an appropriate treatment for people with Type 2 diabetes and obesity not achieving recommended treatment targets with medical therapies, especially in the presence of other major co-morbidities. The procedures must be performed within accepted guidelines and require appropriate multidisciplinary assessment for the procedure, comprehensive patient education and ongoing care, as well as safe and standardized surgical procedures. National guidelines for bariatric surgery need to be developed for people with Type 2 diabetes and a BMI of 35 kg/m² or more.
Asunto(s)
Cirugía Bariátrica/normas , Diabetes Mellitus Tipo 2/prevención & control , Obesidad/cirugía , Adolescente , Adulto , Diabetes Mellitus Tipo 2/cirugía , Determinación de la Elegibilidad/métodos , Femenino , Accesibilidad a los Servicios de Salud/normas , Humanos , Agencias Internacionales , MasculinoRESUMEN
The International Diabetes Federation Taskforce on Epidemiology and Prevention of Diabetes convened a consensus working group of diabetologists, endocrinologists, surgeons and public health experts to review the appropriate role of surgery and other gastrointestinal interventions in the treatment and prevention of Type 2 diabetes. The specific goals were: to develop practical recommendations for clinicians on patient selection; to identify barriers to surgical access and suggest interventions for health policy changes that ensure equitable access to surgery when indicated; and to identify priorities for research. Bariatric surgery can significantly improve glycaemic control in severely obese patients with Type 2 diabetes. It is an effective, safe and cost-effective therapy for obese Type 2 diabetes. Surgery can be considered an appropriate treatment for people with Type 2 diabetes and obesity not achieving recommended treatment targets with medical therapies, especially in the presence of other major co-morbidities. The procedures must be performed within accepted guidelines and require appropriate multidisciplinary assessment for the procedure, comprehensive patient education and ongoing care, as well as safe and standardized surgical procedures. National guidelines for bariatric surgery need to be developed for people with Type 2 diabetes and a BMI of 35 kg/m² or more.
A Força-Tarefa para Epidemiologia e Prevenção da International Diabetes Federation reuniu um grupo de trabalho com diabetologistas, endocrinologistas, cirurgiões e especialistas em saúde pública para revisar o papel correto da cirurgia e outras intervenções gastrointestinais no tratamento e prevenção do diabetes tipo 2 em obesos. Os objetivos específicos foram: desenvolver recomendações práticas para a seleção dos pacientes; identificar barreiras ao acesso à cirurgia e sugerir intervenções para mudanças das políticas de saúde que garantam equidade de acesso à cirurgia, quando indicada, e identificar prioridades para a pesquisa. A cirurgia bariátrica pode gerar uma melhora significativa no controle glicêmico em pacientes com obesidade grave e diabetes tipo 2. Ela é um tratamento efetivo, seguro e de bom custo-benefício para pacientes obesos com diabetes tipo 2. A cirurgia pode ser considerada um tratamento apropriado para pessoas com diabetes tipo 2 e obesidade que não consigam atingir as metas recomendadas de tratamento com terapias medicamentosas, especialmente na presença de outras comorbidades maiores. Os procedimentos devem ser executados por meio de diretrizes aceitas e requerem uma avaliação multidisciplinar, um processo amplo de educação do paciente e cuidados contínuos, além de procedimentos cirúrgicos seguros e padronizados. As diretrizes nacionais para a cirurgia bariátrica devem ser desenvolvidas para pacientes com diabetes tipo 2 e IMC de 35 kg/m² ou mais.