Gastrointestinal surgeries designed to promote weight loss have been shown to improve glucose homeostasis in patients with type 2 diabetes more efficiently than the standard therapeutic approaches, leading to long-term remission in many patients with the disease.
Now, researchers and diabetes clinicians have created a Joint Statement, endorsed so far by 45 international professional societies, claiming that metabolic surgery should be recommended as a treatment option for diabetes patients, particularly for patients who are mildly obese and have not responded to conventional treatments.
The statement and clinical guidelines will be published in the June 2016 edition of Diabetes Care.
The issue will include 10 research studies reporting the latest data that supports metabolic surgery as a new treatment option in the management of type 2 diabetes. The Statement was endorsed by the American Diabetes Association, and supported with a commentary written by Drs. William T. Cefalu, Francesco Rubino, and David E. Cummings.
“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 Cefalu, Diabetes Care editor in chief, in a press release.
Metabolic surgeries are procedures in which parts of the stomach are removed, or the small intestine is rerouted, to reduce nutrient absorption and induce weight loss. The interventions have proven to promote major improvements in glycemia and a reduction in cardiovascular risk factors, rendering them effective in the treatment of type 2 diabetes patients, or in diabetes prevention. But metabolic surgery has not yet been included in clinical guidelines for diabetes care.
Based on a large number of studies revealing that the surgery reduces blood sugar levels, and induces diabetes remission, or helps maintaining glycemic control despite major reduction in diabetes medication, the new Guidelines suggest that surgery should be recommended to obese patients with type 2 diabetes or mildly obese patients, whose glycemic levels are not controlled with medical therapy or lifestyle changes. Surgery should also be considered for overweight patients with inadequately controlled hyperglycemia.
Rubino, professor of Metabolic and Bariatric Surgery at King’s College London, in the U.K., said that surgery represents a radical departure from conventional approaches to diabetes, but is huge in the fight against the disease.
“The new Guidelines effectively introduce, both conceptually and practically, one of the biggest changes for diabetes care in modern times,” Rubino said. “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,”.