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Nuritional care for the remission of type 2 diabetes in adults undergoing metabolic surgery: a narrative review and propose of educational tool


Advances in Obesity, Weight Management & Control
MNC  Soto  Novia Araceli Alejandra,1 MNC Tellez Giron Angelica Leon,2 Perichart Perera Otilia3

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Abstract

Chronic non-communicable diseases (NCDs) are the principal cause of death in the world. In Mexico, type 2 diabetes (T2D) is the leading cause of death. An increase of 5kg/m2 in the body mass index (BMI) significantly increased the mortality by T2D. Metabolic surgery is an alternative treatment for people who are living with obesity and T2D. Metabolic surgical procedures  induce  anatomo-physiological  changes,  which  improves  glycemic  control, decreases the risk of mortality due to T2D, promotes weight loss, and body fat, and in some cases, have the potential for the remission of T2D. These surgeries impact nutritional status in the short, medium and long term, therefore, a nutritionist should evaluate and implement nutrition interventions in these individuals. There are no guidelines for nutrition to promote and maintain remission of T2D in individuals with these types of surgeries. The objective of this review is to summarize current scientific evidence to guide the clinical practice in this context. The therapeutic goals include, besides promoting weight loss, monitor waist circumference  and  body  composition,  evaluation  of  glycemic  control  with  regulation  of  hypoglycemic  drugs,  and  avoiding  nutritional  deficiencies.  For  adequate  results  it  is recommended  to  incorporate  behavioral  strategies  and  nutritional  education  focused  on  healthy and sustainable eating patterns. Adequate nutritional monitoring favors a better prognosis  in  the  fulfillment  of  therapeutic  objectives  of  both  diseases  after  metabolic surgery.

Keywords

bariatricsurgery, nutritional assessment, nutrition intervention, diabetes mellitus type 2, obesity

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