SchauerSurgeryforTDM糖尿病脂肪肝-培训课件.pptVIP

Adverse Events through 36 Months No Difference Between Groups BMJ Oct 22, 2013 11 studies, 796 patients, BMI 27-53 Surgery superior to med Rx Wt. loss, HbA1c, T2DM remission, TG, HDL, remission of metabolic syndrome, QOL, medication reduction No difference in BP or LDL No CV events or death after surgery Anemia (15%), Reoperation (8%) Surgical vs Medical Treatments for Type 2 Diabetes Mellitus: A Randomized Clinical Trial Anita P.?Courcoulas,?MD, MPH; Bret H.?Goodpaster,?PhD; Jessie K?Eagleton,?MPH; Steven H.?Belle,?PhD, MScHyg; Melissa A.?Kalarchian,?PhD; Wei?Lang,?PhD; Frederico G. S.?Toledo,?MD; John M.?Jakicic,?PhDRoux-en-Y Gastric Bypass Surgery or Lifestyle With Intensive Medical Management in Patients With Type 2 Diabetes Feasibility and 1-Year Results of a Randomized Clinical TrialFlorencia?Halperin,?MD; Su-Ann?Ding,?MD; Donald C.?Simonson,?MD, MPH, ScD; Jennifer?Panosian,?BA; Ann?Goebel-Fabbri,?PhD; Marlene?Wewalka,?MD; Osama?Hamdy,?MD, PhD; Martin?Abrahamson,?MD; Kerri?Clancy,?RN; Kathleen?Foster,?RN; David?Lautz,?MD; Ashley?Vernon,?MD; Allison B.?Goldfine,?MD 2 More Recent RCT’s JAMA Surgery June 4, 2014 Both Show Superiority of Surgery vs. Intensive Medical RX International Diabetes Federation Guidelines Surgery should be an accepted option in people who have type 2 diabetes and BMI of 35 or more Surgery should also be considered as an alternative treatment option in persons with BMI 30 to 35 when diabetes cannot be adequately controlled by optimal medical regimen, especially in the presence of other major cardiovascular disease risk factors In Asian, and some other ethnicities of increased risk, BMI action points may be lower e.g. BMI 27.5 to 32.5 Bariatric Surgical and Procedural Interventions in the Treatment of Obese Patients with Type 2 Diabetes Download at Scientific Organizations with Guidelines/Position Statements that Support Metabolic Surgery for Treating T2DM Organization 2008 2014 National Institutes of Health NIH YES YES Nat