SURGICAL INTERVENTIONS IN PATIENTS WITH CROHN'S DISEASE AND TYPE 2 DIABETES: COMBINED MANAGEMENT OF GASTROINTESTINAL AND METABOLIC DISEASES

Abstract

Introduction: Crohn's disease is a chronic inflammatory condition of the gastrointestinal tract, often associated with complications that require surgical interventions. When combined with type 2 diabetes, clinical management becomes more complex, since both conditions affect metabolism and gastrointestinal health. Patients, especially women, may have an increased risk of surgical complications due to insulin resistance and poor wound healing. The combined approach of these diseases requires a multidisciplinary evaluation and careful surgical planning, aiming not only at the resolution of intestinal symptoms, but also at adequate glycemic control. Objective: To explore surgical interventions in patients with Crohn's disease and type 2 diabetes, highlighting the combined management of gastrointestinal and metabolic conditions. Methodology: The methodology followed the PRISMA checklist to ensure quality in the selection of studies. The PubMed, Scielo and Web of Science databases were used, with the descriptors Surgical interventions, Comorbidities, Gastrointestinal diseases, Metabolic diseases and Combined management. Inclusion criteria were: studies addressing surgical interventions in patients with both conditions, publications from the last 10 years, and including data on women. Articles that did not focus on surgical aspects, literature reviews, and studies with very small sample sizes were excluded. Results: The results showed that surgical interventions, such as bowel resection and stoma creation, may be necessary in severe cases of Crohn's disease. The presence of type 2 diabetes was associated with a higher risk of postoperative complications, such as infections and wound healing problems. Concomitant management, which included optimization of glycemic control before surgery, was shown to be crucial to improve surgical outcomes. Conclusion: Surgical interventions in patients with Crohn's disease and type 2 diabetes require careful planning and integrated management of the conditions. The review emphasized the need for a personalized approach, especially for women, in order to optimize clinical outcomes and quality of life.