Generated Narrative: Citation 33089 version: 20; Last updated: 2025-10-13 12:34:35+0000; Language: en Profile: JournalArticleCitation ArtifactPublicationStatus: Active url: https://fevir.net/resources/Citation/33089 identifier: FEvIR Object Identifier/33089, https://pubmed.ncbi.nlm.nih.gov/27222544 title: 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. status: Active author: Computable Publishing®: MEDLINE-to-FEvIR Converter: publisher: Computable Publishing LLC contact: support@computablepublishing.com description: This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide. UseContexts - Code Value[x] * Citation Classification Type: fevir-platform-use (FEvIR Platform Use) Medline Base copyright: https://creativecommons.org/licenses/by-nc-sa/4.0/ approvalDate: 2017-09-28 lastReviewDate: 2022-04-08 classification type: Citation Source classifier: MEDLINE classification type: MEDLINE Citation Owner classifier: National Library of Medicine, Index Section currentState: Medline Citation Status of Medline, PubMed PublicationStatus of ppublish statusDate activity: PubMed Pubstatus of Entrez period: ?? --> 2016-05-26 06:00:00+0000 statusDate activity: PubMed Pubstatus of Pubmed period: ?? --> 2016-05-26 06:00:00+0000 statusDate activity: PubMed Pubstatus of Medline period: ?? --> 2017-09-29 06:00:00+0000 citedArtifact identifier: https://pubmed.ncbi.nlm.nih.gov/27222544, https://doi.org/10.2337/dc16-0236, pii/39/6/861 Titles - Type Text * Primary title Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. Abstracts - Type Text Copyright * Primary human use 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. relatesTo type: Has Comment In classifier: Comment citation: Nat Rev Endocrinol. 2016 Sep;12(9):500-2. doi: 10.1038/nrendo.2016.111. target: https://pubmed.ncbi.nlm.nih.gov/27388983/ relatesTo type: Has Comment In classifier: Comment citation: Diabetes Care. 2016 Nov;39(11):e201. doi: 10.2337/dc16-1416. target: https://pubmed.ncbi.nlm.nih.gov/27926899/ relatesTo type: Has Comment In classifier: Comment citation: Diabetes Care. 2016 Nov;39(11):e202-e203. doi: 10.2337/dci16-0031. target: https://pubmed.ncbi.nlm.nih.gov/27926900/ relatesTo type: Has Comment In classifier: Comment citation: Diabetes Care. 2017 Jul;40(7):e90-e91. doi: 10.2337/dc16-2403. target: https://pubmed.ncbi.nlm.nih.gov/28637891/ publicationForm publishedIn type: Periodical identifier: Electronic ISSN Type/1935-5548, ISOAbbreviation/Diabetes Care, ISSN Linking/0149-5992, Medline Title Abbreviation/Diabetes Care, NLM Unique ID/7805975 title: Diabetes care publisherLocation: United States citedMedium: Internet volume: 39 issue: 6 articleDate: 2016-06 pageString: 861-77 webLocation classifier: Abstract url: https://pubmed.ncbi.nlm.nih.gov/27222544/ webLocation classifier: DOI Based url: https://doi.org/10.2337/dc16-0236 classification type: Publishing Model classifier: Print classification type: MeSH heading artifactAssessment: ArtifactAssessment: artifact[x] = this resource classification type: Publication type classifier: Consensus Development Conference, Journal Article classification type: Knowledge Artifact Type classifier: Journal Article artifactAssessment: Classifier added by Computable Publishing LLC classification type: Citation subset classifier: IM contributorship complete: true entry 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. entry contributor: Zimmet PZ forenameInitials: PZ affiliation: Monash University, Melbourne, Victoria, Australia. entry 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. entry contributor: Kaplan LM forenameInitials: LM affiliation: Harvard Medical School, Boston, MA. entry contributor: Taroncher-Oldenburg G forenameInitials: G affiliation: Philadelphia, PA. entry contributor: Cummings DE forenameInitials: DE affiliation: University of Washington, Seattle, WA francesco.rubino@kcl.ac.uk davidec@u.washington.edu. entry contributor: Delegates of the 2nd Diabetes Surgery Summit Generated Narrative: Practitioner #contributor0 name: Francesco Rubino Generated Narrative: Practitioner #contributor1 name: David M Nathan Generated Narrative: Practitioner #contributor2 name: Robert H Eckel Generated Narrative: Practitioner #contributor3 name: Philip R Schauer Generated Narrative: Practitioner #contributor4 name: K George M M Alberti Generated Narrative: Practitioner #contributor5 name: Paul Z Zimmet Generated Narrative: Practitioner #contributor6 name: Stefano Del Prato Generated Narrative: Practitioner #contributor7 name: Linong Ji Generated Narrative: Practitioner #contributor8 name: Shaukat M Sadikot Generated Narrative: Practitioner #contributor9 name: William H Herman Generated Narrative: Practitioner #contributor10 name: Stephanie A Amiel Generated Narrative: Practitioner #contributor11 name: Lee M Kaplan Generated Narrative: Practitioner #contributor12 name: Gaspar Taroncher-Oldenburg Generated Narrative: Practitioner #contributor13 name: David E Cummings Generated Narrative: Organization #contributor14 name: Delegates of the 2nd Diabetes Surgery Summit Generated Narrative: ArtifactAssessment #meshHeading0 artifact: Citation 27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations. content type: components (if present) include qualifier codings classifier: Algorithms freeToShare: true Components - Type Classifier * qualifier is Major topic content type: components (if present) include qualifier codings classifier: Bariatric Surgery freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: standards Components - Type Classifier * is Major topic Yes content type: components (if present) include qualifier codings classifier: Cardiovascular Diseases freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: prevention & control Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Consensus freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Cooperative Behavior freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Diabetes Mellitus, Type 2 freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: surgery Components - Type Classifier * is Major topic Yes content type: components (if present) include qualifier codings classifier: Endocrinology freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: organization & administration Components - Type Classifier * is Major topic No component type: qualifier classifier: standards Components - Type Classifier * is Major topic Yes content type: components (if present) include qualifier codings classifier: Humans freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Internationality freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Obesity freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: surgery Components - Type Classifier * is Major topic No content type: components (if present) include qualifier codings classifier: Practice Guidelines as Topic freeToShare: true Components - Type Classifier * qualifier is Major topic content type: components (if present) include qualifier codings classifier: Risk Factors freeToShare: true Components - Type Classifier * qualifier is not a major topic content type: components (if present) include qualifier codings classifier: Societies, Medical freeToShare: true component type: qualifier classifier: is not a major topic component type: qualifier classifier: organization & administration Components - Type Classifier * is Major topic No component type: qualifier classifier: standards Components - Type Classifier * is Major topic No
Delegates of the 2nd Diabetes Surgery Summit
components (if present) include qualifier codings
27222544 Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.
Computable Publishing®: MEDLINE-to-FEvIR Converter
This Citation Resource is referenced in an example for the EBMonFHIR Implementation Guide.
National Library of Medicine, Index Section
Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations.
**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.
Classifier added by Computable Publishing LLC
King's College London, London, U.K. francesco.rubino@kcl.ac.uk davidec@u.washington.edu.
University of Colorado Anschutz Medical Campus, Aurora, CO.
Monash University, Melbourne, Victoria, Australia.
University of Washington, Seattle, WA francesco.rubino@kcl.ac.uk davidec@u.washington.edu.