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ADA Gets Behind Bariatric Surgery

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A few weeks ago, we posted a piece by Dr. Nick Yphantides lamenting what he sees as the unquestioned spread of bariatric (weight-loss) surgery. Wisely or not, the surgery is being viewed by more and more people — including doctors — as an option for treating Type 2 diabetes.

In its brand new Standards of Medical Care in Diabetes for 2009, the American Diabetes Association has, for the first time, given the procedure a qualified recommendation. The guidelines say that doctors should consider the surgery for their patients with Type 2 diabetes who have a body-mass index (BMI) of at least 35, especially if their diabetes is difficult to control under current therapy. A recent study, they note, found that adjustable gastric banding caused “remission” of diabetes in 73% of the participants assigned to receive it, compared with only 13% of those assigned to the “best available” nonsurgical treatment.

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The ADA also writes, however, that bariatric surgery carries risks, some of which have not been studied thoroughly. For this reason, it recommends more randomized controlled trials of the surgery that compare it with “optimal medical and lifestyle therapy.”

What do you think — did the ADA jump the gun? Does this make you more likely to consider bariatric surgery? Less likely?

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