Use of Metabolic Surgery for the Treatment of Type 2 Diabetes

Diabetes currently affects more than 220 million people worldwide. This number has increased from 171 million, reported in 2000, and the World Health Organization (WHO) projects this number will reach 366 million by 2030. One of the most significant contributors to the increased prevalence of diabetes is the epidemic of obesity. According to the International Obesity Task Force and the 2002 WHO World Health Report, ~58% of diabetes globally can be attributed to a body mass index (BMI) >21kg/m2. Increasing use of bariatric surgery for the treatment of patients with type 2 diabetes and morbid obesity has been associated with significant improvement and even remission of diabetes in post-surgical patients. This, in turn, has led to significant research into the physiological pathways involved. The current guidelines for bariatric surgery limit its use to patients with diabetes or comorbidities whose BMI is ≥35kg/m2; however, recent studies suggest these guidelines may need to be adjusted to include patients with type 2 diabetes who have a lower BMI.