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Surgery should be standard treatment option for diabetes: guidelines

Xinhua, May 25, 2016 Adjust font size:

New clinical guidelines published Tuesday and endorsed by 45 international diabetes organizations called for bariatric surgery, involving the manipulation of the stomach or intestine, to be considered a standard treatment option for type 2 diabetes.

The guidelines, published in the U.S. journal Diabetes Care, recommended surgery to induce weight-loss for certain categories of people living with type 2 diabetes, including those who are mildly obese and fail to respond to conventional treatment.

The recommendation was based on evidence from 11 clinical trials that bariatric surgery can improve blood glucose levels more effectively than any lifestyle or pharmaceutical interventions in obese people with type 2 diabetes.

Diabetes Care Editor in Chief William Cefalu said in a statement that the new guidelines mark the first time the surgery is recommended as a treatment option specifically for diabetes.

"Given the rapid developments in the field, it is important to focus on this topic for those who care for individuals with diabetes," Cefalu said. "These new Guidelines, based on the results of multiple clinical studies, validate that metabolic surgery is indicated for certain people with diabetes and can yield significantly improved outcomes."

Bariatric surgery involves the removal of part of the stomach or a reroute of the small intestine.

Although it is as safe as other common operations such as gallbladder surgery, there are risks of complications and long-term nutritional deficiencies that require rigorous long-term follow-up by expert teams.

The new guidelines emerged from the Second Diabetes Surgery Summit, an international consensus conference held in London in September 2015 and jointly organized with the American Diabetes Association, International Diabetes Federation, Diabetes UK, Chinese Diabetes Society, and Diabetes India.

According to the new guidelines, bariatric surgery should be recommended to treat patients with type 2 diabetes who have a BMI of 40 and those with a BMI of 30 who are not able to adequately control their blood glucose levels through other means.

These BMI thresholds should be reduced by 2.5 for Asian patients as they develop type 2 diabetes at lower BMI than other populations.

The BMI is a measure of obesity for adult men and women and is calculated by dividing a person's body weight in kilograms by the height in meters squared.

"Surgery represents a radical departure from conventional approaches to diabetes," said Francesco Rubino, a professor of Metabolic and Bariatric Surgery at King's College London in Britain and the first author of the report.

"The new Guidelines effectively introduce, both conceptually and practically, one of the biggest changes for diabetes care in modern times," he added. Enditem