08 Oct 2009
Could gastric bypass or banding operations—known as bariatric surgery—for the treatment of obesity also be a potential cure for diabetes?
Diabetologists, surgeons, and other doctors debated the idea during a special session at the European Association for the Study of Diabetes (EASD) 2009 Meeting last week and at a number of press conferences there.
Use of this type of surgery has conventionally been reserved for those whose body-mass index (BMI) is 35 kg/m2 or greater. Trials in these morbidly obese patients confirm the benefits in terms of weight loss and provide evidence that cardiovascular risk factors are improved as a result, and the surgery can result in remission of diabetes in many cases.
Now, given these encouraging results, there appears to be a downward drift in the criteria for which this procedure is being considered, with many advocating it as a reasonable option for diabetics with a lower BMI (<35) who have failed other attempts at therapy. But this approach is severely hampered by a lack of prospective clinical-trials data on bariatric surgery in this group of patients, a situation that does not seem likely to be rectified anytime soon.