Researchers have said that bariatric surgery has been found to effectively reverse type 2 diabetes in morbidly obese people.
The experts present at the Diabetes Surgery Summit (DSS) suggested that surgery should be considered for the treatment of type 2 diabetes in patients with a BMI of 35 or more who are inadequately controlled by lifestyle and medical therapy.
"With an emphasis on caution and patient safety, the DSS position statement boldly advances a revolutionary concept: the legitimacy of gastrointestinal surgery as a dedicated treatment for type 2 diabetes in carefully selected patients," said lead author Dr. Francesco Rubino, director of the gastrointestinal metabolic surgery program at NewYork-Presbyterian Hospital/Weill Cornell Medical College and associate professor of surgery at Weill Cornell Medical College.
Studies have provided mounting evidence that bariatric surgery effectively reverses type 2 diabetes in a high proportion of morbidly obese patients, sometimes within weeks or even days, well before these patients have lost a significant amount of body weight.
Rubino showed that gastric bypass surgery could improve type 2 diabetes through direct anti-diabetic mechanisms and not solely as a result of weight loss.
"Prevention will always be the best strategy to approach the global epidemic of diabetes," said Rubino.
"But gastrointestinal surgery promises to be an important addition to the armamentarium of available treatments, and its study may also allow us to understand the disease mechanism in depth. We can only prevent what we truly understand," Rubino added.
"This and the remarkable clinical efficacy of gastrointestinal surgery justify considering it as a specific diabetes intervention, rather than viewing diabetes remission merely as a collateral effect of weight-loss surgery," said Dr. David E. Cummings, a leading endocrinologist at the Diabetes and Obesity Centre of Excellence of the University of Washington in Seattle and senior author of the consensus document.
"That understanding may also usher in a new era of drug discovery and development based on the identification of the metabolic pathways and mechanisms that drive the disease."