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Review
, 19 (11), 112

Management of Diabetes in Patients Undergoing Bariatric Surgery

Affiliations
Review

Management of Diabetes in Patients Undergoing Bariatric Surgery

Christopher M Mulla et al. Curr Diab Rep.

Abstract

Purpose of review: The number of bariatric surgeries for patients with type 1 or type 2 diabetes continues to grow. Clinicians are challenged to choose therapies that reach glycemic targets without inducing adverse effects in post-bariatric patients without published guidelines. This review evaluates data supporting the best strategies for diabetes management in patients undergoing bariatric surgery.

Recent findings: Though few clinical trials have evaluated the safety and effectiveness of different glucose-lowering therapies following bariatric surgery, remission of diabetes or reduced medications is an established benefit of bariatric surgery. Adverse events including diabetic ketoacidosis in post-bariatric patients on sodium-glucose co-transporter 2 (SGLT2) inhibitors or inadequate insulin have been reported in patient's with both type 1 and type 2 diabetes. Metformin, glucagon-like peptide-1 (GLP-1) agonists, dipeptidyl peptidase-4 (DPP-4) inhibitors, SGLT2 inhibitors, insulin, and sulfonylureas have been used successfully in the perioperative period for other surgeries and guidelines recommend adjusting the doses of these medications especially in the perioperative period. Clinicians should favor weight-neutral or weight-loss promoting therapies in post-bariatric surgery patients such as medical nutrition therapy, metformin, GLP-1 agonists, SGLT2 inhibitors, and DPP-4 inhibitors.

Keywords: Bariatric surgery; Obesity; Type 1 diabetes; Type 2 diabetes; Weight loss.

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References

    1. Obes Surg. 2016 Sep;26(9):2111-2118 - PubMed

References

    1. Diabetes Obes Metab. 2018 Apr;20(4):1018-1023 - PubMed

References

    1. Diabetes Obes Metab. 2017 Apr;19(4):609-610 - PubMed

References

    1. Diabetes Care. 2019 Jan;42(Suppl 1):S90-S102 - PubMed

References

    1. J Clin Endocrinol Metab. 2015 Jul;100(7):2546-56 - PubMed

References

    1. Obes Surg. 2008 Oct;18(10):1287-96 - PubMed

References

    1. Surg Endosc. 2016 Jul;30(7):2673-8 - PubMed

References

    1. Lancet. 2019 Jan 5;393(10166):31-39 - PubMed

References

    1. J Am Coll Cardiol. 2002 Aug 7;40(3):418-23 - PubMed

References

    1. J Nephrol. 2016 Dec;29(6):783-789 - PubMed

References

    1. JAMA. 2008 Jan 23;299(3):316-23 - PubMed

References

    1. Obes Surg. 2018 Apr;28(4):1080-1085 - PubMed

References

    1. Ther Adv Endocrinol Metab. 2019 Jan 30;10:2042018818822207 - PubMed

References

    1. Diabetes Care. 2016 Jun;39(6):941-8 - PubMed

References

    1. J Surg Case Rep. 2017 Jul 28;2017(7):rjx148 - PubMed

References

    1. Eur Surg Res. 2018;59(5-6):349-360 - PubMed

References

    1. JAMA. 2019 Sep 2;: - PubMed

References

    1. JAMA. 2007 Jul 11;298(2):194-206 - PubMed

References

    1. Diabetes Spectr. 2017 Aug;30(3):202-210 - PubMed

References

    1. Cochrane Database Syst Rev. 2011 Oct 05;(10):CD006423 - PubMed

References

    1. N Engl J Med. 2015 Jul 2;373(1):11-22 - PubMed

References

    1. Obes Surg. 2016 Jan;26(1):196-204 - PubMed

References

    1. Obes Surg. 2018 Mar;28(3):615-626 - PubMed

References

    1. Lancet Diabetes Endocrinol. 2015 Nov;3(11):847-54 - PubMed

References

    1. Diabetologia. 2017 Sep;60(9):1577-1585 - PubMed

References

    1. Curr Diab Rep. 2017 Jul;17(7):54 - PubMed

References

    1. Adv Nutr. 2017 Mar 15;8(2):382-394 - PubMed

References

    1. Endocr Pract. 2013 Mar-Apr;19(2):337-72 - PubMed

References

    1. Curr Obes Rep. 2017 Sep;6(3):253-265 - PubMed

References

    1. Arch Med Sci. 2015 Aug 12;11(4):840-8 - PubMed

References

    1. Diabetes Care. 2016 Jun;39(6):902-11 - PubMed

References

    1. Diabetes Care. 2014 Aug;37(8):e191 - PubMed

References

    1. Diabetes Care. 2016 Apr;39(4):e50-3 - PubMed

References

    1. N Engl J Med. 2017 Feb 16;376(7):641-651 - PubMed

References

    1. Surg Endosc. 2016 Dec;30(12):5428-5433 - PubMed

References

    1. Diabetes Metab Syndr Obes. 2012;5:357-67 - PubMed

References

    1. N Engl J Med. 2019 Jun 6;380(23):2215-2224 - PubMed

References

    1. JAMA. 2018 Oct 16;320(15):1570-1582 - PubMed

References

    1. Diabetes Obes Metab. 2017 Sep;19(9):1223-1232 - PubMed

References

    1. Ann N Y Acad Sci. 2018 Jan;1411(1):53-64 - PubMed

References

    1. Arch Endocrinol Metab. 2018 Apr 05;62(2):172-178 - PubMed

References

    1. Obes Surg. 2017 Aug;27(8):1986-1992 - PubMed

References

    1. Diabetes Care. 2016 Jun;39(6):861-77 - PubMed

References

    1. Obes Surg. 2016 Jun;26(6):1343-51 - PubMed

References

    1. Front Endocrinol (Lausanne). 2019 Jan 15;9:812 - PubMed

References

    1. JCI Insight. 2018 Dec 6;3(23): - PubMed

References

    1. N Engl J Med. 2008 Jun 12;358(24):2545-59 - PubMed

References

    1. Lancet Diabetes Endocrinol. 2014 Jul;2(7):545-52 - PubMed

References

    1. N Engl J Med. 2019 Jun 13;380(24):2295-2306 - PubMed

References

    1. N Engl J Med. 2014 Feb 27;370(9):794-7 - PubMed

References

    1. Diabetes Care. 2018 Apr;41(4):782-788 - PubMed

References

    1. Ann Intern Med. 2018 Sep 4;169(5):300-310 - PubMed

References

    1. Diabetes Care. 2017 May;40(5):687-693 - PubMed

References

    1. J Intern Med. 2013 Mar;273(3):219-34 - PubMed

References

    1. Endocr Pract. 2019 Jan;25(1):69-100 - PubMed

References

    1. Diabetes Care. 2016 Aug;39(8):e121-2 - PubMed

References

    1. N Engl J Med. 2005 Jan 13;352(2):174-83 - PubMed

References

    1. Ann Intern Med. 2019 Feb 5;170(3):155-163 - PubMed

References

    1. Surg Obes Relat Dis. 2011 May-Jun;7(3):257-60 - PubMed

References

    1. Lancet. 2015 Sep 5;386(9997):964-73 - PubMed

References

    1. Exp Clin Endocrinol Diabetes. 2012 Mar;120(3):152-3 - PubMed

References

    1. J Res Pharm Pract. 2017 Apr-Jun;6(2):73-76 - PubMed

References

    1. Diabetes Care. 2011 Jun;34(6):1295-300 - PubMed

References

    1. Best Pract Res Clin Endocrinol Metab. 2009 Aug;23(4):479-86 - PubMed

References

    1. Curr Diab Rep. 2016 Mar;16(3):34 - PubMed

References

    1. JAMA. 2012 Jan 4;307(1):56-65 - PubMed

References

    1. Diabetes Care. 2018 Apr;41(4):e47-e49 - PubMed

References

    1. J Clin Endocrinol Metab. 2016 Jan;101(1):44-51 - PubMed

References

    1. J Am Coll Surg. 2018 Apr;226(4):514-524 - PubMed

References

    1. N Engl J Med. 2012 Aug 23;367(8):695-704 - PubMed

References

    1. Obes Surg. 2004 Oct;14(9):1165-70 - PubMed

References

    1. J Diabetes. 2014 Mar;6(2):100-10 - PubMed

References

    1. Nat Clin Pract Endocrinol Metab. 2005 Nov;1(1):22-31 - PubMed

References

    1. Obes Surg. 2016 Aug;26(8):1697-704 - PubMed

References

    1. Diabetes Res Clin Pract. 2013 Jul;101(1):50-6 - PubMed

References

    1. Lancet Diabetes Endocrinol. 2015 Jun;3(6):413-422 - PubMed

References

    1. J Obes. 2016;2016:6170719 - PubMed

References

    1. J Clin Anesth. 2017 Feb;36:184-188 - PubMed

References

    1. Diabetes Care. 2003 Nov;26(11):3080-6 - PubMed

References

    1. Diabetologia. 2016 May;59(5):945-53 - PubMed

References

    1. Nat Med. 2017 Jul;23(7):850-858 - PubMed

References

    1. N Engl J Med. 2009 Jan 8;360(2):129-39 - PubMed

References

    1. Diabetes Care. 2016 Jun;39(6):912-23 - PubMed

References

    1. Obes Surg. 2018 Jun;28(6):1511-1518 - PubMed

References

    1. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006739 - PubMed

References

    1. Ann Intern Med. 2013 Aug 20;159(4):262-74 - PubMed

References

    1. Nutr Clin Pract. 2014 Dec;29(6):718-39 - PubMed

References

    1. Diabetes Care. 2018 Jun;41(6):1172-1179 - PubMed

References

    1. JAMA. 2015 Jan 6;313(1):62-70 - PubMed

References

    1. Diabetes Care. 2013 Nov;36(11):3430-5 - PubMed

References

    1. Nat Rev Endocrinol. 2017 Aug;13(8):441-442 - PubMed

References

    1. N Engl J Med. 2002 Feb 7;346(6):393-403 - PubMed

References

    1. BMJ Case Rep. 2018 Aug 20;2018:null - PubMed

References

    1. Curr Opin Endocrinol Diabetes Obes. 2014 Oct;21(5):323-9 - PubMed

References

    1. Prim Care Diabetes. 2018 Jun;12(3):265-283 - PubMed

References

    1. Diabetes Technol Ther. 2018 Feb;20(2):127-139 - PubMed

References

    1. Arch Intern Med. 2001 Apr 23;161(8):1106-12 - PubMed

References

    1. Am J Cardiol. 2011 Nov 15;108(10):1499-507 - PubMed

References

    1. Lancet Diabetes Endocrinol. 2015 Jan;3(1):8-10 - PubMed

References

    1. Ann Surg. 2018 May 23;:null - PubMed

References

    1. JAMA Surg. 2014 Jul;149(7):707-15 - PubMed

References

    1. Diabetes Care. 2010 Aug;33(8):1859-64 - PubMed

References

    1. N Engl J Med. 2008 Jun 12;358(24):2560-72 - PubMed

References

    1. Surg Res Pract. 2015;2015:284063 - PubMed

References

    1. Diabetes Care. 2018 Apr;41(4):670-679 - PubMed

References

    1. Diabetes Ther. 2017 Oct;8(5):953-962 - PubMed

References

    1. Endocr Pract. 2016 Jun;22(6):753-62 - PubMed

References

    1. Ann Surg. 2014 Oct;260(4):617-22; discussion 622-4 - PubMed

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