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Type 2 diabetes and metabolic surgery guidelines and recommendations should urgently be unified

Authors
  • Halpern, Bruno1, 2
  • Mancini, Marcio C.1, 3
  • 1 Hospital das Clinicas Universidade de São Paulo,
  • 2 Department of Epidemiology and Prevention, Brazilian Association for the Study of Obesity (ABESO), São Paulo, Brazil
  • 3 Brazilian Society of Endocrinology and Metabolism (SBEM), Rio de Janeiro, Brazil
Type
Published Article
Journal
Acta Diabetologica
Publisher
Springer Milan
Publication Date
Sep 15, 2020
Pages
1–6
Identifiers
DOI: 10.1007/s00592-020-01603-8
PMID: 32930887
PMCID: PMC7491361
Source
PubMed Central
Keywords
License
Unknown

Abstract

Metabolic surgery has been studied in the last decades as an effective and safe treatment for type 2 diabetes (T2D), and randomized controlled trials generally found surgery superior when compared with medical treatment. In 2016, the DSS-II Joint Statement recognized the importance of metabolic surgery in the treatment of T2D and urged clinicians to discuss, recommend, or at least consider this procedure for their patients. Diabetes societies also cogitate metabolic surgery as an option for T2D patients in their guidelines. However, there are some differences in recommendations that could lead a careful reader to some confusion. This was potentialized in a recent document published by the same DSS-II group concerning prioritization for surgery after the COVID-19 pandemic, in which the criteria suggested for an expedited recommendation that is not exactly evidence-based, and collided substantially with several clinical guidelines worldwide, especially with regard to secondary prevention of cardiovascular disease. A more harmonious discussion and unified guidelines between clinicians and surgeons are needed in order to provide the same message for those who read different articles.

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