Review: When should bariatric surgery be used in the treatment of type 2 diabetes?

Abstract

Non-randomised observational studies show that bariatric surgery has a highly beneficial impact on diabetes. Bariatric surgery leads to remission of bariatric surgery has a highly beneficial impact on Diabetes. Bariatric surgery leads to remission of diabetes in at least two thirds of patients, and reductions in drug therapy for many others. Those with more recent onset diabetes, fewer treatment requirements, and able to achieve most weight loss are more likely to achieve remission. Therefore, bariatric surgery is an attractive treatment option to consider for selected more severely obese patients with favourable characteristics. Although data on bariatric surgery in subjects with diabetes are provocative, all recent clinical studies have been uncontrolled or otherwise flawed. Moreover, bariatric surgery has yet to be compared either with medical treatment for weight loss, or against standard medical treatment for diabetes in any randomised controlled trial with diabetes-specific end points. There remains a need for long-term randomised controlled trials before bariatric surgery is used more widely as a first-line treatment for obese patients with type 2 diabetes.