Experts urge more diabetics to get obesity surgery
WASHINGTON — New guidelines say weight-loss surgery should become a more routine treatment option for diabetes, even for some patients who are mildly obese.
Obesity and Type 2 diabetes are a deadly pair, and numerous studies show stomach-shrinking operations can dramatically improve diabetes.
But Tuesday’s guidelines mark the first time the surgery is recommended specifically as a diabetes treatment rather than as obesity treatment with a side benefit, and expand the eligible candidates.
The recommendations were endorsed by the American Diabetes Association, the International Diabetes Federation and 43 other health groups, and published in the journal Diabetes Care.
“We do not claim that surgery should be the firstline therapy,” cautioned Dr. David Cummings, an endocrinologist at the University of Washington and senior author of the guidelines.
But as standard care often isn’t enough, “it’s time for something new.”
About 26 million Americans have diabetes, mostly the Type 2 form where the body gradually loses the ability to produce or use insulin to turn food into energy. Many Type 2 diabetics, although not all, are overweight or obese. Many can control the disease with diet, exercise, medication or insulin — but years of poorly controlled diabetes can lead to heart attacks, strokes, kidney failure, amputations or blindness.
Studies have long shown that most obese diabetics who undergo bariatric surgery see their blood sugar control improve. Some even reach normal levels despite quitting their regular medicine.
Until now, health guidelines have focused on surgery as a last-resort method for the severely obese to lose weight, with diabetes improvement considered a bonus.
Tuesday’s guidelines conclude the surgery should be a regularly considered option for certain diabetes patients — with the emphasis on better blood sugar control instead of pounds lost.
Bariatric surgery — called metabolic surgery when performed for diabetes — has become far less invasive in recent years.
The risk of death or serious side effects from surgery is small and comparable to gallbladder operations or hysterectomies.
Such operations can cost $20,000 to $25,000.
However, insurance coverage varies widely among companies.