title: Perioperative Glycemic Management of Patients Undergoing Bariatric Surgery.
abstract: Bariatric surgery in patients with type 2 diabetes has been shown to improve glycemic control and reduce need for glucose-lowering medications. Some of these improvements occur in the early postoperative period prior to any weight loss. These early reductions in circulating glucose can be attributed to primarily perioperative caloric restriction and prolonged fasting. Inpatient glycemic targets for patients undergoing bariatric surgery are similar to those recommended for other surgical procedures as a way of minimizing risk for complications. There is evidence that achieving perioperative and postoperative glycemic targets can improve the ability to achieve remission of type 2 diabetes following gastric bypass surgery. This review provides recommendations regarding glycemic goals, strategies for achieving these goals with minimal risk for hypoglycemia, and an examination of the data suggesting an association between perioperative glycemic management and diabetes remission following bariatric surgery.
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, University of Pittsburgh Medical Center (UPMC), University of Pittsburgh School of Medicine, 200 Lothrop Avenue, Pittsburgh, PA, 15213, USA. rometoda@UPMC.edu.
authors.forename: David
authors.initials: D
authors.lastname: Rometo
authors.affiliation: Division of Endocrinology, Diabetes, and Metabolism, University of Pittsburgh Medical Center (UPMC), University of Pittsburgh School of Medicine, 200 Lothrop Avenue, Pittsburgh, PA, 15213, USA. mtk7@pitt.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Korytkowski
mesh_terms: D050110:Bariatric Surgery; D001786:Blood Glucose / Q000032:analysis*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D004032:Diet; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy / Q000209:etiology; D019990:Perioperative Care
chemical_list: D001786:Blood Glucose
keywords: Bariatric surgery; Gastric bypass; Insulin; Metformin; Obesity; Perioperative care; Type 2 diabetes