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Bariatric surgery in type 2 diabetes

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Patients need a thorough explanation of the risks Patients need a thorough explanation of the risks and must have realistic expectations of what surgery will achieve

Over a quarter of the adult population in England are now classified as obese (Box 1) and the level is rising rapidly.1 In parallel with this trend is the increasing prevalence of type 2 diabetes, now standing at 6% of adults, around 2.7 million people in England, a figure predicted to rise to 4 million by 2025.2

The objective of bariatric surgery is to enable weight loss in the morbidly obese when lifestyle and pharmacotherapy have proved ineffective. The application of these procedures to patients with type 2 diabetes has the additional benefit of improving glycaemic control and even inducing remission of diabetes.3

Box 1. BMI definition1
Definition BMI (kg/m2)

Overweight 25–30

Obese 30–40

Morbidly obese 40 and over

Despite the high prevalence of obesity in the UK compared to other Western European countries, the development of bariatric surgery is at a relatively low level. In addition, there is much regional variation in the availability of bariatric surgery that depends on the priority which has been allocated to it by clinical commissioning groups.

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