PMID- 28440515
OWN - NLM
STAT- MEDLINE
DCOM- 20170908
LR  - 20181202
IS  - 1671-0274 (Print)
IS  - 1671-0274 (Linking)
VI  - 20
IP  - 4
DP  - 2017 Apr 25
TI  - [Interpretation of the International Joint Statement on Metabolic Surgery in the 
      Treatment Algorithm for Type 2 Diabetes].
PG  - 372-377
AB  - Along with the soaring prevalence of obesity and type 2 diabetes mellitus (T2DM) 
      globally, metabolic and bariatric surgery (MBS) has been rapidly developing into 
      a major surgical subspecialty. However, the indications, benefits and potential 
      risks of MBS are still controversial so far. In September 2015, the 2nd Diabetes 
      Surgery Summit (DSS-II() was successfully convened, and later on an international 
      joint statement on metabolic surgery in the treatment algorithm for T2DM was 
      released based upon the consensus reached in DSS-II(, aiming to serve as a new 
      global clinical guideline. The DSS-II( joint statement was initiated and endorsed 
      by 5 leading international diabetes organizations, including American Diabetes 
      Association (ADA), International Diabetes Federation (IDF), Chinese Diabetes 
      Society (CDS), Diabetes India, as well as Diabetes UK, and was developed by an 
      expert committee comprised of 48 international authorities as voting delegates. 
      Up to the date of publication, the DSS-II( statement has been officially endorsed 
      by 45 international professional associations/societies, including 30 
      non-surgical and 15 surgical organizations. In this statement, the following six 
      aspects were recommended to differentiate MBS from traditional bariatric surgery: 
      1)The primary goal of MBS is to treat T2DM and to reduce the risk of T2DM 
      complications; 2) In addition to a 50% or more of excess weight loss and 
      normalization of glycemia, outcomes of diabetes complications should also be 
      considered as clinical endpoints of MBS; 3) For patient selection, body mass 
      index (BMI), T2DM treatment, as well as long-term risks versus benefits, 
      including its effects on cardiovascular events (CVD), should all be considered; 
      4) T2DM and its complications, as well as pancreatic function reserve should be 
      assessed pre-operatively; 5) Major surgical options include laparoscopic 
      Roux-en-Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LSG), 
      laparoscopic adjustable gastric banding (LAGB), and bilio-pancreatic diversion 
      with duodenal switch(BPD-DS). BPD-DS has the best outcome in T2DM remission 
      followed by LRYGB, LSG and LAGB; 6) Glycemic variation should be intensively 
      monitored, and if needed, managed following surgery. Clinical follow-up should be 
      conducted at least once every six months within two years after surgery. For 
      patients achieving complete remission from T2DM, diabetes complications should 
      still be monitored within five years after surgery with the same frequency and 
      protocols as pre-operatively.
FAU - Zhang, Peng
AU  - Zhang P
AD  - Center of Metabolic and Bariatric Surgery, Fudan University Pudong Hospital, 
      Shanghai 201399, China.
FAU - Zheng, Chengzhu
AU  - Zheng C
AD  - Department of Minimally Invasive Surgery, Shanghai Changhai Hospital, The Second 
      Military Medical University, Shanghai 200433, China. fredzhengzz@hotmail.com.
LA  - chi
PT  - Journal Article
PL  - China
TA  - Zhonghua Wei Chang Wai Ke Za Zhi
JT  - Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
JID - 101177990
RN  - 0 (Blood Glucose)
SB  - IM
MH  - Aftercare/standards
MH  - Bariatric Surgery/*methods/*standards
MH  - Biliopancreatic Diversion
MH  - Blood Glucose/physiology
MH  - Body Mass Index
MH  - Diabetes Mellitus, Type 2/*surgery
MH  - *Disease Management
MH  - Gastrectomy
MH  - Gastric Bypass
MH  - Gastroplasty
MH  - Humans
MH  - Hyperglycemia/surgery
MH  - Laparoscopy
MH  - Obesity/*surgery
MH  - Patient Care Planning/*standards
MH  - Practice Guidelines as Topic/standards
MH  - Remission Induction/methods
MH  - *Treatment Outcome
MH  - Weight Loss
EDAT- 2017/04/26 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/04/26 06:00
PHST- 2017/04/26 06:00 [entrez]
PHST- 2017/04/26 06:00 [pubmed]
PHST- 2017/09/09 06:00 [medline]
AID - 100001882012 [pii]
PST - ppublish
SO  - Zhonghua Wei Chang Wai Ke Za Zhi. 2017 Apr 25;20(4):372-377.