Schauer, P.R., Rubino, F., The IDF Position Statement on Bariatric Surgery for Type 2 Diabetes: Implications for Patients, Physicians and Surgeons, Surgery for Obesity and Related Diseases, (2011), doi: 10.1016/j.soard.2011.05.015.

The International Diabetes Federation (IDF) Position Statement on bariatric surgery co-published in this month’’s issue of Surgery for Obesity and Related Diseases (SOARD) and other obesity, endocrine and diabetes journals is a major step forward in global recognition of metabolic surgery as specific treatment of diabetes, not just obesity. Surgeons, internists, diabetologists, primary care physicians and other health care providers who manage patients with diabetes should carefully read this document as it provides very important, practical, evidenced based recommendations on how to best utilize surgery for treating type 2 diabetes mellitus (T2DM). It is the most comprehensive position statement or guideline yet published.

The Key points of the Position Statement

The IDF expert panel reviewed data related to both conventional, standard bariatric operations as well as novel interventional procedures. For severely obese (BMI >35 kg/m2) diabetic patients the following standard procedures were considered in the clinical recommendations of the IDF statement: gastric banding, sleeve gastrectomy, gastric bypass, biliopancreatic diversion and duodenal switch. There was general agreement that while novel surgical procedures (i.e. Duodenal Jejunal Bypass and Ileal Interposition) and GI device interventions (i.e. endoluminal procedures and electrophysiologic interventions) represent interesting and promising approaches for the treatment of diabetes and obesity, their clinical use should still be considered investigational. Since very few comparative studies have been conducted comparing surgical procedures head to head, the expert panel did not make specific recommendations on specific procedures and called for RCT studies as an important research priority.