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Weight-Loss Surgery Weighed as Diabetes Rx
Date:9/12/2008

Studies show it works but cost, long-term effectiveness unclear

FRIDAY, Sept. 12 (HealthDay News) -- International health experts will convene in New York City next week to discuss an unconventional and arguably radical approach to treating people with type 2 diabetes: weight-loss surgery.

These "bariatric" procedures are normally reserved for the morbidly obese, but recent studies suggest that patients with type 2 diabetes may benefit as well, by improving disease symptoms, often driving it into remission, and reducing the risk of death from the illness.

"We have to address the fact that this could be a potential opportunity for more patients than the ones we have been offering surgery (to) until today," said Dr. Francesco Rubino, chief of gastrointestinal metabolic surgery at Weill Cornell Medical College in New York City, who orchestrated the gathering.

The 1st World Congress on Interventional Therapies for Type 2 Diabetes will serve as a forum for leading surgeons, scientists, endocrinologists and policymakers to examine and debate the evidence. Rubino also hopes to garner consensus on a set of guidelines drafted in Rome last year for the safe use of bariatric surgery in the treatment of diabetes. Without such guidance, "there is a potential for abusing these opportunities," he acknowledged.

In the United States alone, some 24 million people have diabetes, and the majority of these cases are type 2.

While obesity is a risk factor for diabetes, not all diabetics meet current guidelines for bariatric surgery. Generally, surgical candidates must be extremely obese, with a body-mass index (BMI) of 40 or more, or a BMI over 35 with another serious obesity-related medical condition, such as uncontrolled diabetes.

In 2008, an estimated 220,000 bariatric surgeries will be performed in the United States, says the American Society for Metabolic & Bariatric Surgery (ASMBS).

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