News - 29/11/2022
The increasing recognition of the benefits of bariatric surgery has made it possible to take recommendations a step further.
Obesity surgery, also known as bariatric or metabolic surgery, was previously indicated exclusively for patients with severe obesity (Body Mass Index greater than 35).
Following the recommendations of the High Authority for Health, French Social Security did not authorize bariatric surgery for patients with a BMI of less than 35.
This type of surgery has beneficial effects that are not limited to weight loss, but also extend to pathologies associated with obesity, including type 2 diabetes, i.e. diabetes due to excess weight exhausting the secretion of the pancreas; totally different from type 1 diabetes due to a malfunction of the pancreas which will not be cured by surgery but by treatment with insulin.
It is precisely these promising results with regards to type 2 diabetes, which have encouraged health officials recently to extend the criteria for surgery to include patients with a BMI between 30 and 35, who suffer from type 2 diabetes. 2, which is difficult to treat.
According to the HAS press release, posted on October 12, 2022:
“In terms of benefits, the available studies show a remission of diabetes in 30 to 40% of cases three years after surgery. Thus, according to the meta-analysis carried out by the HAS, patients with moderate obesity (grade I), suffering from type 2 diabetes and undergoing metabolic surgery, have at least 2 to 3 times more chance of their diabetes going into remission than a patient being treated with conventional medical care. In terms of risks, the data show that the adverse effects are similar to those of surgery performed in patients with more severe obesity (grade II and III), but this data remains very limited."
In conclusion, patients with type 2 diabetes, with a BMI between 30 and 35, could be eligible for bariatric surgery, if their diabetes is considered difficult to treat by the endocrinologist. The final decision will be made, as per usual, by a multidisciplinary committee, for each patient.
♦To make an appointment with Dr. Bruto Randone, Digestive and Bariatric Surgeon, at the Clinique Internationale du Parc Monceau, 21 Rue de Chazelles, 75017 Paris, France, or at the Clinique Bizet, 23 Rue Georges Bizet, 75116 Paris, France, click on Contact