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For the week ending August 24, 2012
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Last week 561 articles were evaluated via DynaMed's Systematic Literature Surveillance and 241 were added to DynaMed content.
Based on the editors' criteria of selecting "articles most likely to change clinical practice," one article of significant interest was selected for the DynaMed Weekly Update.
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| Feature Article | |
Bariatric Surgery May Reduce Development of Type 2 Diabetes in Obese Patients
Results of a randomized trial reported earlier this year suggested that bariatric surgery may induce remission of type 2 diabetes in obese patients (N Engl J Med 2012 Apr 26;366(17):1577, DynaMed Weekly Update volume 7, issue 18). A new analysis of data from the ongoing Swedish Obese Subjects (SOS) cohort study investigated the relation between bariatric surgery and prevention of type 2 diabetes.
From a cohort of 4,047 obese patients (BMI ≥ 34 kg/m2 in men and ≥ 38 kg/m2 in women) with up to 15 years of follow-up, a group of 1,658 patients who had bariatric surgery were compared to 1,771 matched controls who did not have surgery. All patients were without diabetes at baseline. In the surgery group, 19% had banding, 69% had vertical banded gastroplasty, and 12% had gastric bypass. The controls received usual care, which ranged from no treatment to advanced lifestyle modification interventions. Matching was based on mean group characteristics for the entire SOS cohort using 18 demographic, anthropometric, and psychosocial variables. Significant baseline differences between the groups included higher BMI, blood pressure, total cholesterol, and daily caloric intake in the surgery group (p < 0.001 for each).
During median 10 years follow-up, new-onset diabetes developed in 110 patients in the surgery group and in 392 controls. The overall incidence rates per 1,000 person-years were 6.8 with surgery vs. 28.4 without surgery (p < 0.001, NNT 5 for 10 years) (level 3 [lacking direct] evidence). In a subgroup of 591 patients with impaired fasting glucose at baseline, the incidence rates were 14.8 with surgery vs. 91 without surgery (p < 0.001, NNT 2 for 10 years) (N Engl J Med 2012 Aug 23;367(8):695).
For more information, see the Bariatric surgery topic in DynaMed.
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CME Information
CREDITS
Physicians: 0.25 AMA PRA Category I Credit(s)™
Family Physicians: 0.25 Prescribed credits
Nurse Practitioners: 0.25 Contact hours
Release Date: August 29, 2012
Expiration Date: August 29, 2013
Estimated Completion Time:
15 minutes
There is no fee for this activity.
To Receive Credit
In order to receive your certificate of participation, you should read the information about this activity, including the disclosure statements, review the entire activity, take the post-test, and complete the evaluation form. You may then follow the directions to print your certificate of participation. To begin, click the CME icon at the end of the article.
Program Overview
Learning Objectives
Upon successful completion of this educational program, the reader should be able to:
1. Discuss the significance of this article as it relates to your clinical practice.
2. Be able to apply this knowledge to your patient's diagnosis, treatment and management.
Faculty Information Alan Ehrlich, MD - Assistant Clinical Professor in Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA; Deputy Editor, DynaMed, Ipswich, Massachusetts, USA Michael Fleming, MD, FAAFP - Assistant Clinical Professor of Family Medicine and Comprehensive Care, LSU Health Science Center School of Medicine, Shreveport, Louisiana, USA; Assistant Clinical Professor of Family Medicine, Department of Family and Community Medicine, Tulane University Medical School, New Orleans, Louisiana, USA; Chief Medical Officer, Amedisys, Inc. & Antidote Education Company
Disclosures
Dr. Ehrlich, Dr. Fleming, DynaMed Editorial Team members, and the staff of Antidote Education Company have disclosed that they have no relevant financial relationships or conflicts of interest with commercial interests related directly or indirectly to this educational activity.
No commercial support has been received for this activity.
Accreditation Statements
ACCME: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Antidote Education Company and EBSCO Publishing. Antidote is accredited by the ACCME to provide continuing medical education for physicians. Antidote Education Company designates this enduring activity for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
AAFP: Enduring Material activity, DynaMed Weekly Update, has been reviewed and is acceptable for up to 13 Prescribed credits by the American Academy of Family Physicians. AAFP certification begins March 7, 2012. Term of approval is for one year from this date with the option of yearly renewal. Each Weekly Update is worth .25 Prescribed credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
AANP: This program is approved for 0.25 contact hour of continuing education by the American Academy of Nurse Practitioners.
Program ID: 1102072Z
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