{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T10:52:53Z","timestamp":1761562373012,"version":"build-2065373602"},"reference-count":25,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,6,21]],"date-time":"2018-06-21T00:00:00Z","timestamp":1529539200000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pharmacotherapy"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p>Obesity is a worldwide epidemic often complicated by multiple comorbidities, including type 2 diabetes mellitus (T2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>). Bariatric surgery is an increasingly common and effective weight\u2010loss strategy for obese patients that may result in resolution of metabolic\u2010related disease states, such as T2<jats:styled-content style=\"fixed-case\">DM<\/jats:styled-content>. Although bariatric surgery has many positive outcomes for patients, dietary and pathophysiologic changes can create difficult\u2010to\u2010control blood glucose, especially in the immediate perioperative setting. Depending on oral antidiabetic agent and insulin needs preoperatively, many patients require cessation of oral agents and reduction or cessation of insulin. Unfortunately, despite available perioperative bariatric surgery guidelines, no specific recommendations for perioperative oral antidiabetic agent or insulin management exist. The purpose of this article is to review the current body of evidence for blood glucose management in the setting of bariatric surgery. An English\u2010language PubMed and MEDLINE search was conducted from 1964 through March 2018 using the following search terms alone and in various combinations: <jats:italic>bariatric surgery, gastric banding, laparoscopic sleeve gastrectomy (LSG), Roux\u2010en\u2010Y gastric bypass (RYGB), glucose management, insulin,<\/jats:italic> and <jats:italic>oral antidiabetic agent<\/jats:italic>. Five articles were identified evaluating insulin management in the perioperative bariatric surgery setting, which were separated into two categories: immediate perioperative insulin management and long\u2010term postoperative insulin management. Overall, various blood glucose management insulin protocols were evaluated. All studies included some type of insulin reduction in the perioperative setting. No studies identified specifically evaluated down\u2010titration or discontinuation of oral antidiabetic agents. Given the lack of specific guideline recommendations, limitations of standardized insulin protocols, and inconsistency of outcomes studied, perioperative insulin at reduced doses compared to previous maintenance doses coupled with frequent blood glucose monitoring is reasonable. An opportunity exists for successful protocols to be addressed in future, larger studies.<\/jats:p>","DOI":"10.1002\/phar.2120","type":"journal-article","created":{"date-parts":[[2018,5,3]],"date-time":"2018-05-03T17:09:16Z","timestamp":1525367356000},"page":"663-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Glycemic Management in the Bariatric Surgery Population: A Review of the Literature"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4514-3948","authenticated-orcid":false,"given":"Meredith L.","family":"Howard","sequence":"first","affiliation":[{"name":"Department of Pharmacotherapy University of North Texas System College of Pharmacy Fort Worth Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor D.","family":"Steuber","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Practice Auburn University Harrison School of Pharmacy Huntsville Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1370-4694","authenticated-orcid":false,"given":"Sarah A.","family":"Nisly","sequence":"additional","affiliation":[{"name":"Wingate University School of Pharmacy Wingate North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,6,21]]},"reference":[{"volume-title":"Prevalence of obesity among adults and youth: United States, 2011\u20132014","year":"2015","author":"Ogden CL","key":"e_1_2_6_2_1"},{"key":"e_1_2_6_3_1","unstructured":"American Society for Metabolic and Bariatric Surgery.Obesity in America November 2013. Available from:https:\/\/asmbs.org\/resources\/obesity-in-america. Accessed March 19 2017."},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.292.14.1724"},{"key":"e_1_2_6_5_1","unstructured":"American Society for Metabolic and Bariatric Surgery.Surgery for diabetes 2018. Available from:https:\/\/asmbs.org\/patients\/surgery-for-diabetes. Accessed March 19 2017."},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2005.04.002"},{"key":"e_1_2_6_7_1","unstructured":"American Society for Metabolic and Bariatric Surgery.Bariatric surgery procedures 2017. Available from:https:\/\/asmbs.org\/patients\/bariatric-surgery-procedures. 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