In a unique collaboration, an international group of scientific and medical experts have teamed up to evaluate the appropriate use of bariatric surgery in the treatment of type 2 diabetes. The conference, known as the Diabetes Surgery Summit, was held to review the evidence and develop guidelines for this new field of medicine. Their consensus statement regarding the use and study of gastrointestinal surgery for diabetes was recently published online in the Annals of Surgery.

Currently, bariatric surgery is only recommended for individuals with severe obesity who have not been able to lose weight through non-surgical methods. While diabetes either improves or resolves in the majority of patients who have had bariatric surgery, treating diabetes is not considered the primary purpose of surgical intervention.

Rather than considering diabetes to be a qualifying obesity co-morbidity for bariatric surgery, the DSS position statement recommends the use and study of bariatric surgery, referred to as gastrointestinal surgery, as a specific and legitimate treatment for type 2 diabetes.

Potential candidates for bariatric surgery, as defined by the National Institutes of Health (NIH), are adults with a body mass index (BMI) of 40 or more (about 100 pounds overweight for men and 80 pounds for women) or a BMI between 35 and 39.9 and a serious obesity-related health problem such as type 2 diabetes, coronary heart disease, or severe sleep apnea.

Since the NIH statement was issued in 1991, however, experts in the field of science and medicine have learned significantly more about diabetes, obesity, and surgery. Although the DSS position statement emphasizes caution and patient safety, the group agreed that the arbitrary BMI cutoff at 35 is not a good predictor of whether or not diabetes will go into remission or improve after surgery and that BMI alone is an inadequate measure for patient selection. In patients with full-blown diabetes, other medical factors should be considered and bariatric surgery should not be denied simply because the BMI is less than 35.

The DSS statement is a bold step forward in recognizing the legitimacy of surgical methods to treat diabetes in carefully selected patients. Listed as a priority, the group recommended clinical trials to investigate the exact role of gastrointestinal surgery in diabetic individuals with less severe obesity. This is a pivotal step towards establishing a new medical specialty for diabetes surgery.

Source: Weill Cornell Medical College News Article “Diabetes Surgery Summit Consensus Lays Foundation for New Field of Medicine”