Baker IDI Heart and Diabetes Institute, 99 Commercial Road, Melbourne, Victoria, Australia.
Diabet Med. 2011 Jun;28(6):628-42. doi: 10.1111/j.1464-5491.2011.03306.x.
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/m(2) or more.
国际糖尿病联合会流行病学和预防糖尿病工作组召集了一组糖尿病专家、内分泌学家、外科医生和公共卫生专家组成共识工作组，以审查手术和其他胃肠道干预措施在 2 型糖尿病治疗和预防中的适当作用。具体目标是：为临床医生制定关于患者选择的实用建议；确定手术准入障碍，并提出卫生政策改革干预措施，以确保在需要时公平获得手术；确定研究重点。减肥手术可以显著改善严重肥胖的 2 型糖尿病患者的血糖控制。它是肥胖 2 型糖尿病的一种有效、安全且具有成本效益的治疗方法。对于不能通过药物治疗达到推荐治疗目标的肥胖 2 型糖尿病患者，手术可被视为一种合适的治疗方法，尤其是在存在其他主要合并症的情况下。手术必须在公认的指南内进行，并需要进行适当的多学科评估、全面的患者教育和持续的护理，以及安全和标准化的手术程序。需要为 BMI 为 35kg/m(2)或更高的 2 型糖尿病患者制定减肥手术的国家指南。
