Recommendations address nonsurgical management, prioritization of patients once surgery resumes
WEDNESDAY, May 13, 2020 (HealthDay News) — In a personal view article, published online May 7 in The Lancet Diabetes & Endocrinology, recommendations are presented for the management of bariatric and metabolic surgery patients during the COVID-19 pandemic.
Francesco Rubino, M.D., from King’s College London, and colleagues provide recommendations for management of candidates for bariatric and metabolic surgery and prioritization of access to surgery during the current pandemic.
The authors note that during the most intense phase of the pandemic, most bariatric and metabolic operations should be suspended due to infection risks, factors inherent to the operations, and increased risks for severe COVID-19 complications among patients with obesity and type 2 diabetes. Nonsurgical options can be used to mitigate the harm from delaying surgery, including optimizing glycemic control in patients with type 2 diabetes and dietary or pharmacologic interventions for weight control. For patients who have had surgery, management should include telemedicine strategies. Weight-reducing diabetes medications should be considered in those with persistent or recurrent type 2 diabetes after surgery; weight maintenance should be encouraged to mitigate the risk for disease recurrence in those with type 2 diabetes remission. Once elective operations resume, preference should be given to those with the greatest risk for morbidity and mortality from their disease if it is likely that surgery can reduce this risk.
“Disease-oriented, medically meaningful strategies to triage patients seeking metabolic surgery after the COVID-19 crisis should help prioritize patients in more urgent need, both now and long into the future,” the authors write.
Several authors disclosed financial ties to the pharmaceutical and medical device industries.
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