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The global spread of obesity is driving a parallel pandemic of type-2 diabetes, a disease afflicting >171 million people worldwide, causing 3 million deaths per year. The therapeutic cornerstones for both obesity and type-2 diabetes are diet, exercise, and medication. The long-term success rates of lifestyle modifications can however be disappointing, and despite an ever-increasing pharmacotherapeutics arsenal, adequate glycemic control often remains elusive. Moreover, most diabetes medications promote weight gain, and using them to achieve tight glycemic control increases risks of hypoglycemia.
Patients with a BMI between 30 and 35 kg/m2 (class I obesity) constitute the largest class of obese persons. Millions of these individuals suffer from poorly controlled diabetes despite attempted lifestyle changes and pharmacotherapy; yet this group does not meet the current criteria for bariatric surgery.
In this lecture, Ricardo Cohen discusses whether this type of patients could benefit from metabolic surgery and the results currently available.