It’s been an exciting few weeks – not only are the Canadian Diabetes Association 2013 guidelines out, but so too have the Clinical Practice Guidelines for Bariatric Surgery been updated!

These guidelines, published as a joint effort by the American Association of Clinical Endocrinologists, The Obesity Society, and the American Society for Metabolic & Bariatric Surgery, have some exciting new updates and features.

The guidelines address 7 key questions:

1.  Which patients should be offered bariatric surgery? 

2.  Whic bariatric surgical procedure should be offered? 

3.  How should potential candidates for bariatric surgery be managaed preoperatively? 

4.  What are the elements of medical clearance for bariatric surgery? 

5.  How can early postoperative care be optimized? 

6.  How can optimal follow-up of bariatric surgery be achieved? 

7.  What are the criteria for hospital admission after bariatric surgery?

A few headliners that caught my eye:

1.  Sleeve gastrectomy is no longer considered to be investigational; it is now considered to be a mainstream bariatric procedure. (though it has been ‘unofficially’ considered to be mainstream for some time already)

2.  Emerging data to suggest that bariatric surgery could be offered to patients with a BMI between 30-34.9 with diabetes or the metabolic syndrome, though the current evidence is limited by the small number of patients studied, and the lack of long term outcomes (so far).   See my previous comments on this issue here.

3.  There are excellent preoperative and postoperative checklists to help guide health care providers in terms of what needs to be asked about, checked for, and monitored.

The guidelines are a must-read for anyone involved in the care of bariatric patients.

Dr Sue Pedersen © 2013 

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