27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. - Evidence Based Medicine on FHIR Implementation Guide v2.0.0-ballot

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Example Citation: 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.

Active as of 2024-11-22

Generated Narrative: Citation 33089

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url: Citation 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.

identifier: FEvIR Object Identifier/33089, https://pubmed.ncbi.nlm.nih.gov/27222544, Uniform Resource Identifier (URI)/urn:oid:2.16.840.1.113883.4.642.40.44.15.41

version: 2.0.0-ballot

title: 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.

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date: 2024-11-22 11:53:36+0000

publisher: HL7 International / Clinical Decision Support

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This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.

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Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.

Abstracts
- Text Copyright
*
BACKGROUND: Despite growing evidence that bariatric/metabolic surgery powerfully improves type 2 diabetes (T2D), existing diabetes treatment algorithms do not include surgical options. AIM: The 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, was convened in collaboration with leading diabetes organizations to develop global guidelines to inform clinicians and policymakers about benefits and limitations of metabolic surgery for T2D. METHODS: A multidisciplinary group of 48 international clinicians/scholars (75% nonsurgeons), including representatives of leading diabetes organizations, participated in DSS-II. After evidence appraisal (MEDLINE [1 January 2005-30 September 2015]), three rounds of Delphi-like questionnaires were used to measure consensus for 32 data-based conclusions. These drafts were presented at the combined DSS-II and 3rd World Congress on Interventional Therapies for Type 2 Diabetes (London, U.K., 28-30 September 2015), where they were open to public comment by other professionals and amended face-to-face by the Expert Committee. RESULTS: Given its role in metabolic regulation, the gastrointestinal tract constitutes a meaningful target to manage T2D. Numerous randomized clinical trials, albeit mostly short/midterm, demonstrate that metabolic surgery achieves excellent glycemic control and reduces cardiovascular risk factors. On the basis of such evidence, metabolic surgery should be recommended to treat T2D in patients with class III obesity (BMI ≥40 kg/m(2)) and in those with class II obesity (BMI 35.0-39.9 kg/m(2)) when hyperglycemia is inadequately controlled by lifestyle and optimal medical therapy. Surgery should also be considered for patients with T2D and BMI 30.0-34.9 kg/m(2) if hyperglycemia is inadequately controlled despite optimal treatment with either oral or injectable medications. These BMI thresholds should be reduced by 2.5 kg/m(2) for Asian patients. CONCLUSIONS: Although additional studies are needed to further demonstrate long-term benefits, there is sufficient clinical and mechanistic evidence to support inclusion of metabolic surgery among antidiabetes interventions for people with T2D and obesity. To date, the DSS-II guidelines have been formally endorsed by 45 worldwide medical and scientific societies. Health care regulators should introduce appropriate reimbursement policies.

© 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

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Nat Rev Endocrinol. 2016 Sep;12(9):500-2. doi: 10.1038/nrendo.2016.111

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Diabetes Care. 2016 Nov;39(11):e201. doi: 10.2337/dc16-1416

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Diabetes Care. 2016 Nov;39(11):e202-e203. doi: 10.2337/dci16-0031

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Diabetes Care. 2017 Jul;40(7):e90-e91. doi: 10.2337/dc16-2403

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title: Diabetes care
publisherLocation: United States
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articleDate: 2016-06
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contributor: Rubino F
forenameInitials: F
affiliation: King's College London, London, U.K. francesco.rubino@kcl.ac.uk davidec@u.washington.edu.
entry
contributor: Nathan DM
forenameInitials: DM
affiliation: Harvard Medical School, Boston, MA.
entry
contributor: Eckel RH
forenameInitials: RH
affiliation: University of Colorado Anschutz Medical Campus, Aurora, CO.
entry
contributor: Schauer PR
forenameInitials: PR
affiliation: Cleveland Clinic, Cleveland, OH.
entry
contributor: Alberti KG
forenameInitials: KG
affiliation: Imperial College London, London, U.K.
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contributor: Zimmet PZ
forenameInitials: PZ
affiliation: Monash University, Melbourne, Victoria, Australia.
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contributor: Del Prato S
forenameInitials: S
affiliation: University of Pisa, Pisa, Italy.
entry
contributor: Ji L
forenameInitials: L
affiliation: Peking University, Beijing, China.
entry
contributor: Sadikot SM
forenameInitials: SM
affiliation: Diabetes India, Mumbai, India.
entry
contributor: Herman WH
forenameInitials: WH
affiliation: University of Michigan, Ann Arbor, MI.
entry
contributor: Amiel SA
forenameInitials: SA
affiliation: King's College London, London, U.K.
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contributor: Kaplan LM
forenameInitials: LM
affiliation: Harvard Medical School, Boston, MA.
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contributor: Taroncher-Oldenburg G
forenameInitials: G
affiliation: Philadelphia, PA.
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contributor: Cummings DE
forenameInitials: DE
affiliation: University of Washington, Seattle, WA francesco.rubino@kcl.ac.uk davidec@u.washington.edu.
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