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Sapunar J, Escalona A, Araya AV, Aylwin CG, Bastías MJ, Boza C, Cárcamo C, Csendes A A, Davidof F P, Funke R, Gómez P, González MI, Lahsen R, Lanzarini E, Maíz A, Mujica V, Muñoz R, Pérez G, Raimann F, Salman P, Sepúlveda M, Soto N, Villagrán R. [Consensus statement of the Chilean endocrinological society on the role of bariatric surgery in type 2 diabetes]. Rev Med Chil 2019; 146:1175-1183. [PMID: 30724982 DOI: 10.4067/s0034-98872018001001175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Diabetes Mellitus (DM) and obesity are a public health problem in Chile. Bariatric surgery is the most effective treatment alternative to achieve a significant and sustained weight reduction in patients with morbid obesity. The results of controlled clinical trials indicate that, compared to medical treatment, surgery for obese patients with DM2 allows a better control of blood glucose and cardiovascular risk factors, reduces the need for medications and increases the likelihood for remission. Consensus conferences and clinical practice guidelines support bariatric surgery as an option to treat DM2 in Class III Obesity (Body Mass Index (BMI) > 40) regardless of the glycemic control and the complexity of pharmacological treatment and in Class II Obesity (BMI 35-39,9) with inadequate glycemic control despite optimal pharmacological treatment and lifestyle. However, surgical indication for patients with DM2 and BMI between 30-34.9, the most prevalent sub-group, is only suggested. The Chilean Societies of Endocrinology and Diabetes and of Bariatric and Metabolic Surgery decided to generate a consensus regarding the importance of other factors related to DM2 that would allow a better selection of candidates for surgery, particularly when weight does not constitute an indication. Considering the national reality, we also need a statement regarding the selection and characteristics of the surgical procedure as well as the role of the diabetologist in the multidisciplinary team.
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Affiliation(s)
- Jorge Sapunar
- Departamento de Medicina Interna y Centro EPICYN, Facultad de Medicina, Universidad de la Frontera, Temuco, Chile
| | - Alex Escalona
- Clínica Universidad de los Andes, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | | | - Carmen Gloria Aylwin
- Clínica Universidad de los Andes, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - María Juliana Bastías
- Sección Endocrinología, Diabetes y Nutrición, Departamento de Medicina Interna, Hospital Naval Almirante Nef, Viña del Mar, Chile
| | | | - Carlos Cárcamo
- Instituto de Cirugía, Facultad de Medicina, Universidad Austral de Chile, Valdivia, Chile
| | | | | | | | | | | | | | | | - Alberto Maíz
- Departamento. Nutrición, Diabetes y Metabolismo, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Verónica Mujica
- Facultad de Medicina, Universidad Católica del Maule, Talca, Chile
| | - Rodrigo Muñoz
- Departamento de Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Gustavo Pérez
- Departamento de Cirugía Digestiva, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Félix Raimann
- Centro Integral de Obesidad y Diabetes, Servicio de Cirugía y Endoscopía, Clínica Puerto Varas, Puerto Varas, Chile
| | - Patricio Salman
- Unidad de Endocrinología, Departamento de Medicina Interna, Facultad de Medicina. universidad de Concepción. Concepción, Chile
| | - Matías Sepúlveda
- Hospital de la Dirección de Previsión de Carabineros de Chile (DIPRECA). Santiago, Chile
| | - Néstor Soto
- Unidad de Endocrinología y Diabetes, Servicio de Medicina Interna, Hospital San Borja Arriarán. Santiago, Chile
| | - Rodrigo Villagrán
- Departamento de Cirugía Bariátrica Metabólica, Clínica Bupa Antofagasta. Antofagasta, Chile
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