Recommendations for Bariatric Surgery and Type 2 Diabetes

If you have type 2 diabetes, you may spend your time worrying about blood sugars, HgbA1c, avoiding carbohydrates and wondering about the latest commercial drug for treating diabetes. Until recently, metabolic/bariatric surgery was excluded in every treatment plan for type 2 diabetes, but growing evidence exists showing surgery can improve and possibly cause remission of this disease.

In June of 2016 the 2nd Diabetes Surgery Summit (DSS II) published recommendations regarding metabolic/bariatric surgery and type 2 diabetes in the Diabetes Care journal. For the first time ever, metabolic/bariatric surgery is recommended for people who are struggling to control type 2 diabetes and have a BMI of 30 or higher.

These new guidelines promote using surgeries such as the gastric bypass, sleeve gastrectomy, adjustable gastric band and biliopancreatic diversion for control or remission of type 2 diabetes.

The recommendations advocate using the term metabolic surgery to indicate bariatric surgery with intent to treat type 2 diabetes, shifting the focus of surgery away from just weight control. Current recommendations for bariatric surgery are weight centric and use BMI to establish necessity, usually a BMI of 35 or higher.

These new recommendations will expand access to metabolic surgery to diabetics with class 1 obesity (BMI 30-34.9) and provide for overall better glucose control for the diabetic population.

The benefits of metabolic surgery for type 2 diabetes are more than just better control of blood sugars. Other benefits for patients include medical cost savings, a lower risk of cardiovascular disease and improved quality of life.

These new guidelines will change the treatment of type 2 diabetes and provide better, effective care for diabetics. As new technologies and techniques become available, the day the medical community can say that type 2 diabetes is under control is quickly approaching.

If you or a loved one has type 2 diabetes, talk to your doctor about if these changes affect your current treatment plan.