A first-of-its-kind consensus statement on diabetes surgery was published online yesterday in the Annals of Surgery. The statement was issued following the first international consensus conference, Diabetes Surgery Summit (DSS), where an international group of more than 50 scientific and medical experts agreed on a set of evidence-based guidelines and definitions that are meant to guide the use and study of gastrointestinal surgery to treat type 2 diabetes. 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. This position is based on a mounting body of evidence showing 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.
In its position statement, the Diabetes Surgery Summit states, “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.” The statement goes on to state that diabetes surgery may also be appropriate for treatment of people with type 2 diabetes and merely mild-to-moderate obesity (BMI 30-35). This goes beyond parameters established by the NIH for bariatric surgery in 1991, which reserved bariatric surgery for people with a BMI of 35 or more with an obesity-related condition, or a BMI of 40 or more with or without any obesity-related condition. These parameters are still adhered to by most insurance companies in determining coverage of the surgery.
The Diabetes Surgery Summit was held at the Catholic University of Rome, Italy, under the auspices of 22 international medical and scientific organizations, including the American Diabetes Association, the American Society for Metabolic and Bariatric Surgery, Diabetes United Kingdom, The Obesity Society and the European Association for the Study of Diabetes.
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