Weight loss surgery is effective in treating diabetes in obese people, according to the medical fraternity.
A new position statement from the International Diabetes Federation (IDF) says that bariatric surgery should be considered earlier as a cost-effective treatment option for severely obese people with type 2 diabetes.
"Bariatric intervention is a health and cost-effective therapy for type 2 diabetes and obesity with an acceptable safety profile. Bariatric surgery for severely obese people with type 2 diabetes should be considered much earlier in management rather than held back as a last resort. It should be incorporated into type 2 diabetes treatment protocols," said IDF co-chairperson Prof Sir George Alberti, senior research investigator, Imperial College, London.
He also pointed out that the cut-points for action may be lower in Asian populations because of their increased risk of diabetes and heart disease.
The IDF is recommending surgery for patients with a body mass index of 35 or more.
"Bariatric surgery is a treatment that can be recommended for people with type 2 diabetes and obesity not achieving recommended treatment targets with existing medical therapies, especially when there are other major co-morbidities such as hypertension, high cholesterol or sleep apnea, " said Prof Paul Zimmet AO, Director Emeritus, Baker IDI Heart and Diabetes Institute, Melbourne, and co-chairperson.
"Surgery should be an accepted option in people who have type 2 diabetes and a body mass index (BMI) of 35 or more. The procedures must be performed within accepted guidelines and require appropriate multidisciplinary assessment prior to surgery and on-going care as well, " he said.
"It is very important for health authorities and policy makers to understand that almost all severely obese patients cannot achieve and maintain significant weight loss. They should be treated where appropriate with bariatric surgery, which can lead to remission of diabetes in up to 80% of patients," said Prof John Dixon, Head of Obesity Research Unit, Department of General Practice, Monash University, Melbourne.
The expert group cautioned the situation in low- and middle-income nations presents special problems because severe obesity is increasing at an alarming rate.
As health care resources are limited, bariatric surgery should only be performed where the health budget can afford it, and when the expertise is available for both the surgery and the long-term follow-up.
The statement was released at the 2nd World Congress on Interventional Therapies for Type 2 Diabetes in New York.