FOREST HILLS, NY – Weight-loss surgery should be an option for type 2 diabetic patients who are mildly obese and fail to respond to conventional treatment, say medical experts.
The recommendation, published in the journal Diabetes Care, comes from the American Diabetes Association, the International Diabetes Federation and 43 other health organizations.
Based on data collected worldwide from more than 11 clinical trials involving bariatric (weight-loss) surgery, the findings are a major game changer in the fight to control blood sugar.
“We have known for a long time that bariatric surgery is effective in treating diabetes, but there’s been some resistance from the primary care and endocrinology community in formally acknowledging that,” said Allison Barrett, MD, a bariatric surgeon at Long Island Jewish Forest Hills Hospital.
“Now that the American Diabetes Association officially supports bariatric surgery in the treatment of diabetes, it changes the triage pattern for patients with diabetes,” she continued. “Healthcare providers will be much quicker to seek bariatric surgery as an option for treatment, whereas before they were focused on using medications.”
While medications can help manage diabetes, they cannot cure it, explained the surgeon.
“Overweight diabetics who cannot control their condition with medication need permanent weight loss in order resolve their diabetes, and that is what you get with bariatric surgery,” said Dr. Barrett.
There are several types of bariatric surgery which involve either reducing the size of the stomach or rerouting the small intestine.
Current guidelines require bariatric surgery candidates to have a BMI of 35 or greater, which is a rough estimate of body fat based on height and weight calculations. The new recommendation calls for consideration that the BMI requirement be lowered to 30 to 34.9 in those with inadequately controlled high blood sugar.
But that won’t happen overnight, cautions Dr. Barrett, because large-scale studies need to be done on lower BMI patients in order to get approval and acceptance from insurance companies and the medical community.