Following two recent studies that have claimed weight loss, or bariatric surgery is the best way to treat obese patients with type 2 diabetes, warnings have been issued that not all such patients are good candidates for the treatment.
The Endocrine Society has called for more stringent monitoring of the surgery and that clinicians should also take into account a range of other factors, such as body mass index (BMI), age and length of time with diabetes, as well as the ability to make changes to long-term lifestyle. They said that neither study highlighted other risks from the surgery, which include nutritional and metabolic complications.
In one of the studies that the Endocrine Society examined, the average glycated haemoglobin levels dropped substantially in patients who had gastric bypass and sleeve gastrectomy surgery as compared with patients who were only on medical therapy. The other involved a major reduction in HbA1c levels for patients having either gastric bypass surgery or biliopancreatic diversio, as compared with just medical therapy. Both studies had observed no deaths linked with the surgery, but that there were some less severe complications.
The report from the society argued that “Sustained long-term benefits will require maintenance of the metabolic changes achieved. Bariatric surgery is not a guarantee of successful weight loss and maintenance.”

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