American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic &amp; Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient

Mechanick, Jeffrey I.; Kushner, Robert F.; Sugerman, Harvey J.; González-Campoy, J. Michael; Collazo–Clavell, Maria L.; Guven, Safak; Spitz, Adam F.; Apovian, Caroline M.; Livingston, Edward H.; Brolin, Robert E.; Sarwer, David B.; Anderson, Wendy; Dixon, John; Brett, Elise M.; Hamdy, Osama; McMahon, M. Molly; Yu, Yi-Hao; Fujioka, Ken; Cummings, Susan; Sogg, Stephanie; Schauer, Philip; Shikora, Scott A.; Ponce, Jaime; Sarr, Michael G.

doi:10.4158/ep.14.s1.1

Cited by 281 publications

(421 citation statements)

References 687 publications

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“…Another limitation is that the information about arterial hypertension was self-reported by patients who knew they had been diagnosed with hypertension or were in use of some anti-hypertensive drug, not patients who showed elevated BP on the day of the OGTT. It is not possible to be sure of the operative technique employed either, since the "Roux-en-Y" gastric bypass information was also reported by the patients, and this could be due to the fact that the Roux-en-Y technique is currently the most commonly used (24,25) (nearly 80% of the surgical procedures for the treatment of obesity) (13). Even if the surgery was in fact Roux-en-Y gastric bypass, there are variations in the technique, e.g., the placement of the ring of containment around the pouch, size of the gastric pouch, among others, that could determine variations in the presence and intensity of the symptoms of dumping.…”

Section: Discussionmentioning

confidence: 99%

Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients

Andrade¹,

Pedrosa²,

Diniz³

et al. 2016

Arch. Endocrinol. Metab.

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Objective: The oral glucose tolerance test (OGTT) is used in the screening of gestational diabetes, in diagnosis of type 2 diabetes in conjunction with fasting blood glucose and glycated hemoglobin. The aim of this study was to examine the incidence and risk factors of adverse effects of OGTT in patients who underwent bariatric surgery, in addition to proposing standardization for ordering the OGTT in these patients. Subjects and methods: This study assessed the incidence of adverse effects in 128 post-bariatric surgery patients who underwent the OGTT. Descriptive and logistic regression analysis were performed, the dependent variables were defined as the presence of signs (tremor, profuse sweating, tachycardia), symptoms (nausea, diarrhea, dizziness, weakness), and hypoglycemia (blood glucose ≤ 50 mg/dL). Results: One hundred and seventeen participants (91.4%) were female; 38 (29.7%) participants were pregnant. High incidence (64.8%) of adverse effects was observed: nausea (38.4%), dizziness (30.5%), weakness (25.8%), diarrhea (23.4%), hypoglycemia (14.8%), tachycardia (14.1%), tremor (13.3%), profuse sweating (12.5%) and one case of severe hypoglycemia (24 mg/dL). The presence of signs was associated with hypoglycemia (OR = 8.1, CI 95% 2.6-25.1). The arterial hypertension persisted as a risk factor for the incidence of signs (OR = 3.6, CI 95% 1.2-11.3). Fasting glucose below 75 mg/dL increased the risk of hypoglycemia during the test (OR = 9.5, CI 95% 2.6-35.1). Conclusion: In this study, high incidence of adverse effects during the OGTT was observed in post-bariatric surgery patients. If these results are confirmed by further studies, the indication and regulation of the OGTT procedure must be reviewed for these patients. Arch Endocrinol Metab.2016;60(4):307-13

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Section: Discussionmentioning

confidence: 99%

Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients

Andrade¹,

Pedrosa²,

Diniz³

et al. 2016

Arch. Endocrinol. Metab.

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“…In comparison with purely restrictive procedures, more extensive perioperative nutritional evaluations are required for gastric bypass and even more ''aggressive'' malabsorptive procedures such as biliopancreatic diversion [190].…”

Section: Postoperative Nutritionmentioning

confidence: 99%

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

et al. 2016

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Background During the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based ''enhanced'' perioperative protocol. Methods The English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation. Results Although for some elements, recommendations are extrapolated from non-bariatric settings (mainly colorectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials. Conclusions A comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.

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“…16 Selection criteria for weight loss surgery were based on guidelines provided by the American Association of Clinical Endocrinologists, The Obesity Society and the American Society for Metabolic and Bariatric Surgery. 7 We do, however, have a large number of patients waiting to be seen in our program, and we triaged according to the severity of comorbidities and the probability of benefit. Eighty percent of the patients enrolled into the preoperative assessment phase had type 2 diabetes mellitus.…”

Section: Discussionmentioning

confidence: 99%

“…Selection criteria for weight loss surgery were based on guidelines provided by the American Association of Clinical Endocrinologists, The Obesity Society and the American Society for Metabolic and Bariatric Surgery. 7 Patients with a BMI greater than 40 or a BMI greater than 35 with at least 1 obesity-related comorbidity were considered potential candidates. A large number of patients are waiting to be seen in our program, and all consultations were triaged.…”

Section: Preoperative Carementioning

confidence: 99%

Laparoscopic sleeve gastrectomy: perioperative outcomes, weight loss and impact on type 2 diabetes mellitus over 2 years

Hoogerboord

Wiebe

Klassen

et al. 2014

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American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for Clinical Practice for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient

Cited by 281 publications

References 687 publications

Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients

Adverse effects during the oral glucose tolerance test in post-bariatric surgery patients

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations

Laparoscopic sleeve gastrectomy: perioperative outcomes, weight loss and impact on type 2 diabetes mellitus over 2 years

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