International Diabetes Federation (IDF) Issues Statement on Bariatric Surgery

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On March 28th, at the 2nd World Congress on Interventional Therapies for Type 2 Diabetes in New York, the IDF Taskforce on Epidemiology & Prevention issued their first statement on bariatric surgery. The central theme of the report is reflected in this quote from paragraph 2.15: "...bariatric surgery for the severely obese with type 2 diabetes should be considered early as an option for eligible patients, rather than being held back as a last resort."  

Some additional interesting points from the statement:

  • The report asserts that access to bariatric surgery for obese type 2 diabetics is restricted both financially and clinically, due to the lack of provider awareness of efficacy and low risk profiles. 
  • The statement echos guidelines for bariatric surgery in adolescents made by the Australian and New Zealand Colleges for paediatric physicians and surgeons, and the Obesity Surgery Society of Australia and New Zealand (BMI > 40 with severe comorbidities, only LAGB & RNY considered appropriate).  VSG still excluded for adolescents due to lack of long term data.
  • In paragraph 3.1.1, the report states that "under some circumstances people with a BMI 30-35 should be eligible for surgery," but falls short of explicitely describing those circumstances.
  • The Taskforce redirects the requirements for economic analysis back to "each health system," who must individually "determine whether bariatric surgery with its support services is economically appropriate." Based on their reported data, bariatric surgery is indeed cost effective in the treatment of type 2 diabetes, yet this guidance suggests that new economic analysis be undertaken at the initiation of each program.
  • Section 2.18 addresses "Novel extra-luminal and endo-luminal procedures and devices and novel bariatric metabolic devices."  

Type 2 diabetes is one of the world's fastest growing diseases, with obesity as its greatest single risk factor -- 450 million people worldwide are forecast to have the disease by 2030.

The full report is available here.