Rometo David, Korytkowski Mary
Division of Endocrinology, Diabetes, and Metabolism, University of Pittsburgh Medical Center (UPMC), University of Pittsburgh School of Medicine, 200 Lothrop Avenue, Pittsburgh, PA, 15213, USA.
Curr Diab Rep. 2016 Apr;16(4):23. doi: 10.1007/s11892-016-0718-6.
Bariatric surgery in patients with type 2 diabetes has been shown to improve glycemic control and reduce need for glucose-lowering medications. Some of these improvements occur in the early postoperative period prior to any weight loss. These early reductions in circulating glucose can be attributed to primarily perioperative caloric restriction and prolonged fasting. Inpatient glycemic targets for patients undergoing bariatric surgery are similar to those recommended for other surgical procedures as a way of minimizing risk for complications. There is evidence that achieving perioperative and postoperative glycemic targets can improve the ability to achieve remission of type 2 diabetes following gastric bypass surgery. This review provides recommendations regarding glycemic goals, strategies for achieving these goals with minimal risk for hypoglycemia, and an examination of the data suggesting an association between perioperative glycemic management and diabetes remission following bariatric surgery.
2型糖尿病患者接受减肥手术已被证明可改善血糖控制，并减少降糖药物的使用需求。其中一些改善发生在术后早期，即在体重减轻之前。循环葡萄糖的这些早期降低主要可归因于围手术期热量限制和长时间禁食。减肥手术患者的住院血糖目标与其他外科手术推荐的目标相似，以此将并发症风险降至最低。有证据表明，实现围手术期和术后血糖目标可提高胃旁路手术后实现2型糖尿病缓解的能力。本综述提供了关于血糖目标的建议、以最低低血糖风险实现这些目标的策略，以及对表明围手术期血糖管理与减肥手术后糖尿病缓解之间存在关联的数据的审视。
