Cigrovski Berkovic M, Bilic-Curcic I, Mrzljak A, Canecki Varzic S, Cigrovski V. Prehabilitation of overweight and obese patients with dysglycemia awaiting bariatric surgery: Predicting the success of obesity treatment. World J Diabetes 2022; 13(12): 1096-1105 [PMID: 36578866 DOI: 10.4239/wjd.v13.i12.1096]
Corresponding Author of This Article
Maja Cigrovski Berkovic, MD, PhD, Adjunct Associate Professor, Department of Endocrinology, Diabetes and Clinical Pharmacology, Clinical Hospital Dubrava, Gojaka Suska 6, Zagreb 10000, Croatia. maja.cigrovskiberkovic@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Diabetes. Dec 15, 2022; 13(12): 1096-1105 Published online Dec 15, 2022. doi: 10.4239/wjd.v13.i12.1096
Prehabilitation of overweight and obese patients with dysglycemia awaiting bariatric surgery: Predicting the success of obesity treatment
Maja Cigrovski Berkovic, Ines Bilic-Curcic, Anna Mrzljak, Silvija Canecki Varzic, Vjekoslav Cigrovski
Maja Cigrovski Berkovic, Department of Endocrinology, Diabetes and Clinical Pharmacology, Clinical Hospital Dubrava, Zagreb 10000, Croatia
Maja Cigrovski Berkovic, Vjekoslav Cigrovski, Faculty of Kinesiology, University of Zagreb, Zagreb 10000, Croatia
Ines Bilic-Curcic, Silvija Canecki Varzic, Faculty of Medicine University of Osijek, Osijek 31000, Croatia
Ines Bilic-Curcic, Silvija Canecki Varzic, Department of Endocrinology and Diabetes, Clinical Hospital Centre Osijek, Osijek 31000, Croatia
Anna Mrzljak, Department of Gastroenterology and Hepatology, University Hospital Center Zagreb, Zagreb 10000, Croatia
Anna Mrzljak, School of Medicine, University of Zagreb, Zagreb 10000, Croatia
Author contributions: Cigrovski Berkovic M conceived and wrote the original draft; Bilic-Curic I, Canecki Vrazic S, Mrzljak A and Cigrovski V were involved in data collection and analysis and writing the manuscript; all authors approved the final version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maja Cigrovski Berkovic, MD, PhD, Adjunct Associate Professor, Department of Endocrinology, Diabetes and Clinical Pharmacology, Clinical Hospital Dubrava, Gojaka Suska 6, Zagreb 10000, Croatia. maja.cigrovskiberkovic@gmail.com
Received: July 21, 2022 Peer-review started: July 21, 2022 First decision: September 4, 2022 Revised: September 9, 2022 Accepted: November 2, 2022 Article in press: November 2, 2022 Published online: December 15, 2022 Processing time: 147 Days and 4 Hours
Abstract
Bariatric surgery offers the best health results in overweight and obese patients but is not a risk and/or complication-free treatment. In cases with additional hyperglycemia, the burden of surgery can be even higher and alter both short-term and long-term outcomes. Although bariatric surgery offers glycemic improvements and in the case of early onset diabetes disease remission, weight loss results are lower than for obese patients without diabetes. Different multimodal programs, usually including interventions related to patients’ performance, nutritional and psychological status as well as currently available pharmacotherapy before the surgery itself might considerably improve the immediate and late postoperative course. However, there are still no clear guidelines addressing the prehabilitation of obese patients with dysglycemia undergoing bariatric surgery and therefore no unique protocols to improve patients’ health. In this minireview, we summarize the current knowledge on prehabilitation before bariatric surgery procedures in patients with obesity and dysglycemia.
Core Tip: The prehabilitation of bariatric surgery patients is an insufficiently investigated area of research. Adequate perioperative preparation for patients awaiting bariatric surgery could present one of the main determinants of predicting the success of surgical treatment, especially in patients with associated dysglycemia. A combination of calorie restrictive diet, structured exercise program, psychological support, and anti-obesity pharmacotherapy should be implemented in the perioperative care of candidates for bariatric procedures. This multimodal approach has the most promising potential to promote 5% weight loss at least thus affecting chronic inflammation and insulin resistance, the main culprits of bariatric surgery resistance.
