Bariatric surgery may be a legitimate way to address diabetes

Implications: Diabetes continues to be a global problem with hefty costs in dollars, death and disability.  Over the years treatment has not varied much-exercise, diet and use of insulin- and the problem continues to grow. If bariatric surgery shows amelioration of diabetes (if "cure" is too strong a worrd),  then surgery should  be considered a legitimate option in some cases.

Analysis: The incidence of diabetes is increasing with growing physical inactivity and obesity worldwide. Diabetes and its sequalae like amputations, blindness, ESRD and so on cause the healthcare system dearly. A diabetic is several times more likely to use the healthcare system on an ongoing basis (including inappropriate use of the ED)  than individuals with any other primary diagnosis. Treatment for diabetes has been pretty constant with minor tweaks such as closer monitoring, and the type and delivery system for insulin. Even identification of "bad food" has run the gamut and come back full circle. So it makes sense to consider other viable options.

In the overwhelming majority of cases-something like 80% to 90% of  diabetics who undergo bariatric surgery- there is a great amelioration of diabetic symptoms, reduction or total freedom from insulin or oral meds.

One colleague I contacted indicated that his hospital charges between $25000 and $35000 for each bariatric surgery. Such incremental revenue could prove very attractive in an industry always seeking additional revenue.

I have heard stories about hyperthyroidism and osteoporosis developing post bariatric surgery. But the benefits certainly outweigh the risks in this case, I think.

Those of us in healthcare are critical of anything seen as a quick fix. However -along with commonsense practices like regular exercise, a healthy diet, continued management of other health issues- bariatric surgery should eb considered adjunctive therapy for treating diabetes.