What Moderately Heavy Type 2 Diabetics Need to Know About Weight Loss Surgery
Here’s what the American Diabetes Association has to say about weight loss surgery for treating your type 2 diabetes even if you are only moderately heavy.
According to a special issue of Diabetes Care Reports, clinical guidelines for when to consider weight loss surgery as a treatment for people with diabetes was recently announced recommending that metabolic surgery should be considered as a treatment option for certain categories of people with diabetes―including people who are mildly obese and fail to respond to conventional treatment.
Here is a news video about the report:
The Changing Picture of Diabetes Treatment
Previously, to qualify for bariatric weight loss surgery, a patient had to typically be clinically diagnosed as morbidly obese or have a BMI of over 35 and experiencing a severe comorbid condition such as high blood pressure.
However, only recently are health experts noting that with the failure of current non-surgical methods to help many with diabetes; and, the fact that bariatric surgery often quickly and dramatically improves blood glucose control, that new clinical practice guidelines should be enacted to include recommending bariatric surgery to help patients with diabetes.
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According to the ADA:
"Given the rapid developments in the field, it is important to focus on this topic for those who care for individuals with diabetes. 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," said Diabetes Care Editor in Chief William T. Cefalu, MD, adding that it is the first time guidelines recommend surgery as a treatment option specifically for diabetes.
Diabetes Patients Recommended for Weight Loss Surgery
According to the new guidelines, metabolic surgery should be recommended for:
• Type 2 diabetes in patients with Class III obesity (BMI greater than or equal to 40 kg/m²).
• Type 2 diabetes Class II obesity (BMI between 35 and 39.9 kg/m²) when hyperglycemia is inadequately controlled by lifestyle and medical therapy.
• Type 2 diabetics who have a BMI between 30 and 34.9 kg/m² if hyperglycemia is inadequately controlled.
• Asian patients, who develop type 2 diabetes at lower BMI than other populations, should be included at a BMI lowered by 2.5 kg/m² for each of the above categories.
"Surgery represents a radical departure from conventional approaches to diabetes. The new Guidelines effectively introduce, both conceptually and practically, one of the biggest changes for diabetes care in modern times," said Dr. Francesco Rubino, a Professor of Metabolic and Bariatric Surgery at King's College London in the UK, co-director of the DSS-II and the co-author of the report. "This change is supported by documented clinical efficacy and by the evidence of an important role of the gut in metabolic regulation, which makes it an appropriate target for anti-diabetes interventions," he added.
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“Metabolic Surgery for Type 2 Diabetes: Changing the Landscape of Diabetes Care” Diabetes Care 2016 Jun; 39(6): 857-860; William T. Cefalu et al.
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