{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T22:21:48Z","timestamp":1791498108104,"version":"4.3.4"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T00:00:00Z","timestamp":1773619200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabet Med"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The global prevalence of obesity and diabetes continues to rise, with metabolic\u2010bariatric surgery recognised as an effective intervention for obesity and type 2 diabetes, offering potential for type 2 diabetes remission and improved glycaemic control. This guideline, developed by the Joint British Diabetes Societies for Inpatient Care (JBDS\u2010IP), provides recommendations for the management of diabetes in individuals undergoing metabolic\u2010bariatric surgery. It emphasises the importance of multidisciplinary care and individualised treatment plans to optimise outcomes. Key recommendations include pre\u2010operative glycaemic optimisation, targeting HbA1c &lt;69\u2009mmol\/mol (&lt;8.5%) where safe to do so, prevention of hypoglycaemia throughout all phases of care and providing a framework for medication adjustments during the liver reduction diet (LRD), peri\u2010operative and post\u2010operative phases. For type 2 diabetes, oral and non\u2010insulin therapies such as metformin, DPP4 inhibitors and GLP\u20101 based therapies may be continued during LRD, while sulfonylureas, meglitinides and SGLT2 inhibitors should be discontinued to reduce the risk of hypoglycaemia. For those with type 2 diabetes on insulin, doses should be reduced by 35%\u201350% during LRD and adjusted post\u2010operatively based on individual glycaemic control. To prevent diabetic ketoacidosis (DKA) in those with type 1 diabetes, insulin must never be stopped and careful planning with diabetes teams is essential. Post\u2010operatively, regular glucose monitoring, hypoglycaemia surveillance, medication adjustments, and follow\u2010up with diabetes specialists are recommended. This document serves as a guide for clinicians and service commissioners, aiming to improve inpatient diabetes care and outcomes for individuals undergoing metabolic\u2010bariatric surgery.<\/jats:p>","DOI":"10.1111\/dme.70281","type":"journal-article","created":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T05:25:49Z","timestamp":1773725149000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Diabetes management in people undergoing metabolic\u2010bariatric surgery: A guideline from the Joint British Diabetes Societies for Inpatient Care (\n                    <scp>JBDS<\/scp>\n                    \u2010\n                    <scp>IP<\/scp>\n                    ) Group"],"prefix":"10.1111","volume":"43","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-086X","authenticated-orcid":false,"given":"Jeffrey W.","family":"Stephens","sequence":"first","affiliation":[{"name":"Swansea University  Swansea UK"},{"name":"Swansea Bay University Health Board  Swansea UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3619-9579","authenticated-orcid":false,"given":"Ketan","family":"Dhatariya","sequence":"additional","affiliation":[{"name":"Norfolk &amp; Norwich University Hospitals NHS Foundation Trust  Norwich UK"},{"name":"University of East Anglia  Norwich UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Beamish","sequence":"additional","affiliation":[{"name":"Swansea Bay University Health Board  Swansea UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8798-920X","authenticated-orcid":false,"given":"Dimitri J.","family":"Pournaras","sequence":"additional","affiliation":[{"name":"North Bristol NHS Trust  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3830-3173","authenticated-orcid":false,"given":"Alexander D.","family":"Miras","sequence":"additional","affiliation":[{"name":"Ulster University  Derry\u2010Londonderry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6452-1273","authenticated-orcid":false,"given":"Nader","family":"Raafat","sequence":"additional","affiliation":[{"name":"Homerton Healthcare NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Noble\u2010Bell","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6322-8043","authenticated-orcid":false,"given":"Rachel","family":"Cadwallader Buckland","sequence":"additional","affiliation":[{"name":"Hull University Teaching Hospitals NHS Trust  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3123-809X","authenticated-orcid":false,"given":"Omar G.","family":"Mustafa","sequence":"additional","affiliation":[{"name":"King's College Hospital NHS Foundation Trust  London UK"},{"name":"King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-022-06332-1"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/obr.13087"},{"issue":"1","key":"e_1_2_11_4_1","first-page":"S1","article-title":"American Association of Clinical Endocrinologists, The Obesity Society, and American Society for Metabolic & Bariatric Surgery Medical Guidelines for clinical practice for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient","volume":"17","author":"Mechanick JI","year":"2009","journal-title":"Obesity (Silver Spring)"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2022.05.008"},{"key":"e_1_2_11_6_1","volume-title":"Guideline for Perioperative Care for People with Diabetes Mellitus Undergoing Elective and Emergency Surgery","author":"Centre for Perioperative Care","year":"2023"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2012.03582.x"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-018-3389-3"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soard.2016.03.020"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.16541"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.2337\/dci21-0034"},{"key":"e_1_2_11_12_1","volume-title":"Type 2 Diabetes in Adults: Management \u2010 NICE Guideline Reference Number (NG28) 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