Certified Diabetes Care and Education Specialist (CDCES) Practice Exam

According to the 2023 ADA recommendations, metabolic surgery should be considered for what criteria in patients with type 2 diabetes?

1. Patients who have tried numerous dietary options to lose weight without success

2. Patients with weight-related comorbidities that are potentially life-threatening

3. Patients whose BMI is greater than 35 and have had difficulty with glycemic control

4. There are no criteria as the ADA does not recommend bariatric surgery at this time

The correct answer is: Patients whose BMI is greater than 35 and have had difficulty with glycemic control

The recommendation for considering metabolic surgery, particularly in patients with type 2 diabetes, is specifically aimed at individuals with a body mass index (BMI) greater than 35 who have demonstrated difficulty in achieving adequate glycemic control. This is because obesity is a significant risk factor for the progression and severity of type 2 diabetes, and traditional weight loss methods may not always be effective for every patient. When a patient's BMI exceeds 35, it indicates a higher level of obesity which is often associated with increased health risks and complications related to diabetes management. This population may benefit from metabolic surgery, also known as bariatric surgery, as it can lead not only to substantial weight loss but also to significant improvements in glycemic control, reduction in diabetes-related complications, and even remission of the disease in some cases. The other criteria mentioned, while they may have some relevance in discussions around metabolic health and obesity, do not encompass the specific focus of the ADA guidelines on BMI and glycemic control, making the understanding of these guidelines essential for effective patient management and treatment planning.