Adipositas – Neue Aspekte in der internistischen Betreuung vor und nach bariatrischer Chirurgie

Zusammenfassung

Die Indikation zur bariatrischen oder metabolischen Chirurgie ist in erster Linie an den Body-Mass-Index (BMI) gekoppelt. Neuere Studienergebnisse zeigen jedoch, dass der metabolische Erfolg operativer Maßnahmen von anderen Prädiktoren abhängig ist. Daher ist eine Veränderung der Indikationsgrundlage insbesondere für die chirurgische Therapie des Typ 2 Diabetes mellitus notwendig. Die Nachsorge sollte neben der alimentären Überwachung auch mögliche postbariatrische Hypoglykämien sowie Knochendichtemessungen beinhalten. Zudem ist eine psychologische Mitbetreuung auch postoperativ sinnvoll.

Abstract

Indication for bariatric or metabolic surgery depends primarily on body mass index. Recent study results however suggest, that other markers are more reliable predictors of metabolic success. A revision of indication criteria is therefore necessary especially for surgical therapy of type 2 diabetes mellitus. Postoperative management should include screening for postbariatric hypoglycemia and bone density. Furthermore psychologic surveillance is recommended.

Schlüsselwörter

bariatrische Chirurgie - Typ 2 Diabetes mellitus - Hypoglykämie - Nachsorge

Keywords

bariatric surgery - type 2 diabetes mellitus - hypoglycemia - postoperative management

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