Surgery to constrict the gastrointestinal tract is a safe and effective procedure to control type 2 diabetes in those who are morbidly obese, according to an authority in the field.

"Bariatric surgery controls obesity, which in turn controls diabetes," assistant professor of surgery Gregory F. Dakin told the International Conference on Childhood Diabetes and Obesity, which met recently in Abu Dhabi, United Arab Emirates.

An individual is morbidly obese when his body mass index (BMI) is 40 or above. Severe obesity afflicts those with a BMI of 35-39. Weight-loss surgery is allowed for these two groups of people, but they must also have complicating conditions such as diabetes and high blood pressure.

"There are numerous surgeries currently offered, including gastric bypass, adjustable gastric banding, sleeve gastrectomy and duodenal switch," Dakin said.

The surgery generally results in the loss of some 50 percent to 70 percent of an individual's excess weight - and, in a majority of cases, the complete reversal of diabetes.

"One important meta-analysis showed complete resolution [of diabetes] in over 70 percent of patients," he noted. "Another comparative study showed a 96 percent reduction in diabetes-related deaths after bariatric surgery compared to control patients."

Dakin speculated on the mechanism involved in the alleviation of diabetes, saying that, although weight loss and lower caloric intake obviously play a role, there are other factors, too. Various studies suggest that doctors' surgical manipulation of the stomach and small intestine in bariatric surgery may affect the production of certain hormones, leading to an anti-diabetes effect. As researchers come to better understand this effect, they may find new ways of treating diabetes.

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