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

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.