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Metabolic surgery for T2DM

50 organisations recommend metabolic surgery for T2DM

Guidelines summarised in a booklet - ‘Surgical Treatment for Type 2 Diabetes Summary of the Recommendations and Guidelines from the 2nd Diabetes Surgery Summit (DSS-II)

A joint statement, ‘Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations’, endorsed by 50 international organizations and published in the journal Diabetes Care, has have called for metabolic surgery to be recommended or considered as a treatment option for some people with Type 2 diabetes. The special issue of Diabetes Care sets out the first clinical guidelines for when to recommend or consider metabolic surgery as treatment for people with Type 2 diabetes.

Surgical Treatment for Type 2 Diabetes Summary of the Recommendations and Guidelines from the 2nd Diabetes Surgery Summit (DSS-II)

The guidelines have also been summarised in a booklet. ‘Surgical Treatment for Type 2 Diabetes Summary of the Recommendations and Guidelines from the 2nd Diabetes Surgery Summit (DSS-II),’ created with the support of King’s College London and through an unrestricted educational grant from Ethicon. To access and/or download these guidelines, please click here or on the booklet image opposite. 

Francesco Rubino

"Surgery represents a radical departure from conventional approaches to diabetes. The new guidelines effectively introduce one of the biggest changes for diabetes care in modern times," said Francesco Rubino, a Professor of Metabolic and Bariatric Surgery at King's College London, Consultant Surgeon at King's College Hospital and first author of the paper. “The new guidelines emerged from the Second Diabetes Surgery Summit (DSS-II), an international consensus conference held in September 2015 at King's College London, and jointly organised with Diabetes UK, the American Diabetes Association, International Diabetes Federation, Chinese Diabetes Society, and Diabetes India.”

A second paper, ‘Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results’, published in Diabetes Care explores the costs and benefits of meeting potential demand for metabolic surgery in the UK and US. The paper examines conceptual and practical barriers to the surgery identified through a Policy Lab hosted at the 3rd World Congress on Interventional Therapies for Type 2 Diabetes in September 2015 at King's.

"The case for increasing the uptake of bariatric/metabolic surgery appears strong enough to engage policymakers and practitioners in a concerted discussion of how best to use surgical resources in conjunction with other interventions in good diabetes practice,” said Professor Jennifer Rubin from the Policy Institute at King's which hosted the Policy Lab.

In a Comment, Medical research: Time to think differently about diabetes’, published in Nature, Professor Rubino warns that capitalising on these latest insights about how to treat Type 2 diabetes will require a shift in mindsets across healthcare and research.

Long-standing preconceptions will need to be put aside to effectively tackle the rising rates of diabetes across the globe, particularly in low- and middle-income countries where surgery is not likely to be available for most patients.

The broad endorsement of surgery as a treatment option should inspire fresh approaches in research, writes Professor Rubino. Researchers and clinicians are already trying to mimic the effects of gastrointestinal surgery using less invasive interventions. Pharmacological interventions that target mechanisms of metabolic regulation within the gut are also being investigated.

To access the paper, Metabolic Surgery in the Treatment Algorithm for Type 2 Diabetes: A Joint Statement by International Diabetes Organizations, please click here

To access the paper, Identifying Barriers to Appropriate Use of Metabolic/Bariatric Surgery for Type 2 Diabetes Treatment: Policy Lab Results, please click here

To access the Comment, Medical research: Time to think differently about diabetes, please click here

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